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@  chuck57thSig : (30 October 2014 - 05:51 PM) Sarti07, It's Under (Va Claims And Research) Http://www.hadit.com/forums/topic/59064-Prep-For-Decision-Phaseprovisional-Rating/
@  sarti07 : (30 October 2014 - 02:43 PM) Hello, I Just Posted A Topic About Prep For Decision.. I Have No Idea Where To Find It! Lol
@  carlie : (28 October 2014 - 03:42 PM) Reelnrod - Just Pick A Topic That Corresponds To Your Stuff And Post It
@  reelnrod : (28 October 2014 - 10:11 AM) So, How Do I Post A Topic?
@  Thadine : (28 October 2014 - 08:21 AM) Irrrl
@  Thadine : (28 October 2014 - 08:18 AM) Fishing License
@  Thadine : (28 October 2014 - 08:14 AM) Thadine Quick
@  red : (27 October 2014 - 12:14 PM) Anyone Heard Any Updates On Flying Space A For 100% Disabled Vets?
@  maxwell18 : (27 October 2014 - 10:49 AM) I Did Contact My Congressman Jeff Miller, Let's See What Will Happen
@  maxwell18 : (27 October 2014 - 10:48 AM) @britton
@  Tbird : (27 October 2014 - 04:26 AM) Thank You Larry S For Your Contribution To Our Funding Campaign
@  britton : (26 October 2014 - 07:33 PM) Everyone (Veteran's) Should Recive A Memo From The Dept Of Veterans Affairs ****notification Of Medication Scheduling Change****
@  britton : (26 October 2014 - 07:24 PM) Meds That Are Consider To Be Schedule Ii Narcotic...pain Meds Like Hydrocodone Ectt Ect,,
@  britton : (26 October 2014 - 07:22 PM) As I Understand We Only Can See The Va Dr's Every 28 Days To Renew Our Prescription Meds A New Law Went Into Effect Oct 6Th 2014....i Only See Problems Problems Problems With This...grrrrr
@  maxwell18 : (26 October 2014 - 03:52 PM) This Is Maxwell18 Would The Person Who Contacted Me (Vern2) Please Contact Me Again, I Attemped To E Mail You It Returned No Reply. Thanks
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@  Notorious Kelly : (25 October 2014 - 07:53 PM) Max- Contact Your Congressman- Dea Has Got Docs So Cowed They're Afraid To Dispense Tylenol
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100% Ptsd Rating That I Don't Want

100% PTSD Rating

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22 replies to this topic

#1 Koalabiter

 
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Posted 26 January 2012 - 06:03 PM

WARNING, LONG POST

I'll go ahead and clear the air here; I know this is going to upset a lot of Veterans that have been seeking a strong rating and have been denied. My apologies, I'm not trying to sound ungrateful here.

Here's the situation:
I am a full-time educator who has been working for several months (successfully). I was at a 50% PTSD rating for the the past four years, but recently went in for my re-evaluation. Terrified of the outcome and possible reduction, I went in prepared; I had my list of symptoms, I wrote down the worst days I've had recently, and I was open and honest with the evaluator. Today, I received notice that my rating for PTSD and depression has been raised to 100%.

The money would be nice. I have a family and am expecting another child soon, but I still don't want this rating.
I need to work. Structure and implied hierarchies rule my life. I have a routine that I daily and any deviation from this ruins the entire day. If they took my job away, I would genuinely lose it. . .

Here are the reasons I want to lose this rating:
1. I'm terrified of losing my routine and know full well that a new one wouldn't be good for me. The paycheck from the VA would be more than I could make at my job (teachers have a salary ladder) until about five years from now. If I have this much money coming in, I'll get stuck in a rut that I will never break free from.

2. I'm terrified about coming to grips with my condition. Yes, I have some problems. No, I don't think they are severe enough to warrant this decision. I'm able to work. I need to work. If I don't contribute something to the world then I'm lost. I know Vets who cannot function in daily society, and I'm not one of them. I don't want to take away from the people who really need this benefit.

3. I'm worried what others think. Yes, I know it's shallow, but I spend the majority of my time analyzing others. One of my conditions is that I've lost the ability to respond well socially; I'm emotionally numb unless I'm chemically altered. With a 50% rating, my friends, family (and possibly employers) think I've got a "little baggage." With 100%, I doubt they could ever look at me the same. Those that love me will question whether I'm going to do something drastic, and those who don't will judge me and may think I'm faking.

I'm grateful that the VA took the time and genuinely listened to me, but I think they're overdone it. Can anyone tell me how to rectify this situation? I don't want benefits I don't believe I'm entitled to. I don't want the VA to think I inflated my condition for profit, and I don't want to lose the one thing that keeps me from crawling into a hole (job).

How long can i continue to work before they come after me? I'd at least like to finish up the school year. If I break contract (even though it would be for good reason) I would really destroy my chances of ever teaching again. It's a small town, who would hire me after that?

Thanks for all the help.

#2 sleeper692

 
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Posted 26 January 2012 - 09:27 PM

Is your rating for 100% TDIU?

I'm no expert, but from what I understand, if you are rated 100% but NOT TDIU, you can continue to work and earn as normal.

I could be wrong. Hopefully a mod will chime in with more info. If I'm right, then you are good to go.

#3 Chuck75

 
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Posted 26 January 2012 - 10:52 PM

You do have the option of asking the VA to reduce the 100% rating. The VA may reduce the rating, and possibly even below the previous 50% rating, based upon current "evaluation" and rating. In other-words, you really don't want to do this without serious cause.

If you are 100% "scheduler", and not "TDIU", you can legally continue to work.
A 100% rating for PTSD often carries some repercussions. The VA may propose that they appoint a "fiduciary", who takes control of your VA payments, and possibly other income (not really according to the law, but it has been known to happen.) You may loose the right to own and carry a firearm. Reducing the rating will not automatically remove these repercussions.

The VA seems to want to ignore the differences between suffering from PTSD and incompetent to manage, or sanity.
The VA has the right to order a review and re-evaluation, and propose a reduction, based upon "new" or updated findings or exams.
Even though the rating may become "protected" the VA still can order a re-evaluation
Will the VA even look to see if you continue to be employed ? Usually not, unless you are rated 100% TDIU.



WARNING, LONG POST

I'll go ahead and clear the air here; I know this is going to upset a lot of Veterans that have been seeking a strong rating and have been denied. My apologies, I'm not trying to sound ungrateful here.

Here's the situation:
I am a full-time educator who has been working for several months (successfully). I was at a 50% PTSD rating for the the past four years, but recently went in for my re-evaluation. Terrified of the outcome and possible reduction, I went in prepared; I had my list of symptoms, I wrote down the worst days I've had recently, and I was open and honest with the evaluator. Today, I received notice that my rating for PTSD and depression has been raised to 100%.

The money would be nice. I have a family and am expecting another child soon, but I still don't want this rating.
I need to work. Structure and implied hierarchies rule my life. I have a routine that I daily and any deviation from this ruins the entire day. If they took my job away, I would genuinely lose it. . .

Here are the reasons I want to lose this rating:
1. I'm terrified of losing my routine and know full well that a new one wouldn't be good for me. The paycheck from the VA would be more than I could make at my job (teachers have a salary ladder) until about five years from now. If I have this much money coming in, I'll get stuck in a rut that I will never break free from.

2. I'm terrified about coming to grips with my condition. Yes, I have some problems. No, I don't think they are severe enough to warrant this decision. I'm able to work. I need to work. If I don't contribute something to the world then I'm lost. I know Vets who cannot function in daily society, and I'm not one of them. I don't want to take away from the people who really need this benefit.

3. I'm worried what others think. Yes, I know it's shallow, but I spend the majority of my time analyzing others. One of my conditions is that I've lost the ability to respond well socially; I'm emotionally numb unless I'm chemically altered. With a 50% rating, my friends, family (and possibly employers) think I've got a "little baggage." With 100%, I doubt they could ever look at me the same. Those that love me will question whether I'm going to do something drastic, and those who don't will judge me and may think I'm faking.

I'm grateful that the VA took the time and genuinely listened to me, but I think they're overdone it. Can anyone tell me how to rectify this situation? I don't want benefits I don't believe I'm entitled to. I don't want the VA to think I inflated my condition for profit, and I don't want to lose the one thing that keeps me from crawling into a hole (job).

How long can i continue to work before they come after me? I'd at least like to finish up the school year. If I break contract (even though it would be for good reason) I would really destroy my chances of ever teaching again. It's a small town, who would hire me after that?

Thanks for all the help.


Edited by Chuck75, 26 January 2012 - 10:59 PM.


#4 carlie

 
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Posted 26 January 2012 - 10:59 PM

Chuck,
He posts that he is now rated 100 percent - for PTSD.

100 Percent solely for a MH disability and working is a NO - NO.

#5 jbasser

 
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Posted 26 January 2012 - 11:10 PM

Carlie is right. The regs actually state for 100 present the condition precludes working.

#6 carlie

 
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Posted 26 January 2012 - 11:18 PM

The OP does not want the additional money or evaluation of 100 % - because he is
doing good working and feels it is beneficial to him.

He was granted 100% due to findings on a re-evaluation done at VBA's request.

He wants to find a way to get VA to not rate him at 100 %.

I think he would prefer a rating of 50 - 70 percent.

How should he handle this.

(At least this is my understanding)

#7 Koalabiter

 
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Posted 27 January 2012 - 07:51 AM

Carlie, you're absolutely correct.

I was awarded 100% for a combination of PTSD and Depression, but I want to reduce (or lose at this point) the rating because I don't want to quit working.
Work keeps me moving and focused. Telling me to stay at home would essentially be a death sentence in my eyes.

I plan on appealing, but don't want to have to quit work in the meantime. I teach in a small town, and dropping out during this part of the year (regardless of reason) would be a black mark on my teaching record from which I could never recover. It's sad to say this type of discrimination exists, but I'm not foolish enough to ignore it.

Thoughts?

#8 evandc

 
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Posted 27 January 2012 - 08:57 AM

Dear VA,

I don't need your money. Please give it to a vet that needs it.

Sincerely,

The Veteran

#9 carlie

 
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Posted 27 January 2012 - 11:27 AM

As long as you continue to honestly report your income (each year the VA will send a VA Form), why not let the VA make the decision to propose a change? ~Wings


I don't see that VA will send him an income verification form - he's 100 % scheduler - not IU.

#10 carlie

 
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Posted 27 January 2012 - 11:30 AM

I plan on appealing, but don't want to have to quit work in the meantime.


Koal,
This would not be something to appeal.
Do you have a service officer ?
Perhaps it would help you decide what to do if you went and talked
with a service officer.
JMHO

#11 Philip Rogers

 
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Posted 27 January 2012 - 12:59 PM

Koalabiter - unless you have stated to them that you are "unemployable" there is no reason to do anything. The criteria listed for someone rated 100% schedular, for a mental disorder, includes terms that suggest the person can't work, however one does not need to meet all the criteria, to be rated 100% schedular. As long as you have done nothing that could be construed as being fraudulent, I'd continue to work and accept their rating & compensation. "They've" decided you are 100% schedular, not you. Now if the rating is "TDIU" then my recommendation would be different.

As Chuck75 mentioned you can be 100% schedular and work. No where does it specify that you can't work if rated 100% schedular, for a mental disorder.

At worst, the VA will reevaluate you at a later date and then propose a reduction. I, personally, think you are safe. You can always bank the money, in a separate account, if you feel you could end up having to pay it back. I have never heard of a case where someone rated 100% schedular was prosecuted for working. jmo

pr

#12 carlie

 
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Posted 27 January 2012 - 01:54 PM

This thread goes together with the following one.

http://www.hadit.com...__fromsearch__1

#13 Wings

 
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Posted 27 January 2012 - 09:25 PM

I don't see that VA will send him an income verification form - he's 100 % scheduler - not IU.


You're right. No VA Forms, and he says in the title he's also Permanent and Total. SO, that means no re-exams either.

#14 Wings

 
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Posted 28 January 2012 - 12:37 PM

x
x
x

I'm sorry I didn't really listen to what you were saying here, in your first message. I reflexively responded with the assumption that you had been awarded "unemployable" (TDIU). I lost a little sleep thinking about how painful it's been for me, personally, to feel that I have accomplished to little professionally. My career in the military was cut short due to my inability to overcome the emotional and scars of an in-service rape trauma. Because I did not recieve help from the military or the VA when I was discharged (and I knocked at that door loudly and repeatedly), my pproblems only worsened and I found myself totally unable to secure employment. All that said, if I could trade my VA comp for a successful career with positive self esteem, I would do it in an instant, even if the pay was less!

IMO, If you are able to work, then you should not have a 100% schedular rating. HOWEVER, I also read into your message that you have been working successfuly for only 4 months? I don't know what that's about, but if it has anything to do with your PTSD, I'd say you are not out of the woods just yet! I think you should wait on making a permanent decision, and see what how rest of the school year pans out. Unless you have lied to the VA during your C&P Exam, and did in fact produce an honest occupational history, then you are under no lawful obligation to tell the VA that your life has improved permanently! I'm sorry to suggest that it is common for a PTSD veteran to have ups and downs, flareups, a sudden exacerbation of symptoms, and even good days.

Sounds like you landed a good job after some years of marginal employement? and you want to keep it --and I think you should try. But you probably should wait it out and see what happens. No reason just yet to feel like a fraud! Your VA Award was in all likelihood justified by the evidence at the time the rating was assigned. IMO, again --if you are still doing well in a year's time, I would feel morally obligated to write to the VA for a re-examination, or go to the VA for your mental health treatment and tell them how things are going ... Sorry I didn't listen and hear what you were saying the first time. ~Wings

#15 john999

 
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Posted 29 January 2012 - 12:22 PM

One big factor with a gamble on keeping 100% rating is your age. If you are 28 or even 38 I would probably gamble. If you are 58 I would not gamble. If I was 100% schedular and working I would keep working until the VA proposed a reduction. You have time to bolster your SSA and any pension benefits you might have coming. At age 40 you can't see the future that by age 50 you really will be totally disabled. It happened to me and came as quite a shock. I am glad I was able to work for 20 years, but I was also low balled for 20 years. When I got out of the army at age 21 I was totally disabled, but the VA did not see it that way. With 15 years of psychotherapy I was able to hold a job for 20 years. I am now better off than someone who has was disabled from age 21, but it is just an accident. The VA's treatment of those with emotional disabilites is so counterproductive and usually ends up hurting the vet in the long term. They punish attempts to rehabilitate yourself. Why is a mental disability different than a physical disability? Nobody tells a double amputee to just shut up and take the money. The VA will bend over backwards to rehabilitate that amputee. Everyone in society applauds when an brain damaged vet or amputee gets a job. They accuse a PTSD vet of being a fraud if he works.

John
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#16 xpertshot

 
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Posted 03 February 2012 - 12:43 PM

This topic was very interesting to read. Thanks for posting and for the wonderful comments.

For a long time, I felt as if I was worthless, unbable to keep a job longer than 6-8 months. More recently, I have been unemployed for over 3 years. How I wish I could find a company that would hire me into a job that I could feel proud of. Unfortunetly, thats not going to happen to me anymore. Filling out the applications they ask for five to ten years work experience. I never have enough room to list all my past employers in the space provided. Not having a VA rating didnt help with the situation and explanation to potential employers or with family. All I could reply to their questions of why I can't handle keeping a job was that I had put in a claim with the VA and that I believed the result would be in my favor.

Today I can now say that I am rated by the VA, but the gaps in employment havent changed. Looking at my own work history and recent work experience, I would not hire myself either. I dont blame the hiring managers for passing me up, and I dont feel I owe anyone (employers or family) any explanations.

Having received my award didnt change how i feel or how i see things. If i went back to work I know I would eventually suffer the same outcome as my previous 12 jobs. I dont see how having money, or having a "good" job can change how a disabled vet (especially ptsd) feels or how it eases his/her symptoms of ptsd. I thought that getting my retro pay would change my life and i would be able to "live" better. The joy and excitement went away in as little as a couple days.

Sorry this was long and personal to me, but i find this as helpful therapy to be able to discuss my thoughts and personal views. Again, great post and topic discussion!

#17 vet12

 
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Posted 04 February 2012 - 04:28 PM

If it doesn't work out to your satifaction with the VA, could you volunteer in some type of teaching capacity?
Then maybe it could be a win/win for you. jmo vet12

#18 Fco75th25div

 
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Posted 30 July 2012 - 06:14 PM

Just voluneer your time without pay.....Keep your disablityVA check, the professional declared you 100% You can donate time and it's
not reportable or tracked by the government.....

#19 Joey Clancy

 
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Posted 17 May 2013 - 06:51 PM

I'm 100% service connected by the VA, but I don't want them anymore.



#20 john999

 
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Posted 18 May 2013 - 09:39 AM

Just put the 100% money aside and keep working. If the VA had granted me 100% when I really had a chance to rehab myself I would have kissed the ground.



#21 OEFMP

 
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Posted 26 May 2014 - 04:12 PM

Hey guys I'm going to piggy back alittle off this forum. But I was wondering if anyone could maybe give me a ballpark figure from my PTSD C&P exam? Thanks in advance.

 

 

1. Diagnostic Summary

---------------------

Does the Veteran have a diagnosis of PTSD that conforms to DMS-5 criteria

based on today's evaluation?

[X] Yes [ ] No

2. Current Diagnoses

--------------------

a. Mental Disorder Diagnosis #1: PTSD

ICD code: F43.1

b. Medical diagnoses relevant to the understanding or management of the

Mental Health Disorder (to include TBI): See below.

Comments, if any: CPRS indicates 30% service-connection for:

IMPAIRED HEARING (0%-SC)

PARALYSIS OF MEDIAN NERVE (10%-SC)

TINNITUS (10%-SC)

LUMBOSACRAL OR CERVICAL STRAIN (10%-SC)

PARALYSIS OF SCIATIC NERVE (10%-SC)

LIMITED FLEXION OF FOREARM (0%-SC)

Computerized records indicate:

Knee pain

Tobacco Dependence

Overweight

Tinnitus, Subjective

Elevated Liver Function Tests

Lumbar Radiculopathy

Degen Disc Dis, Lumbar

Hearing loss

Low Back Pain

3. Differentiation of symptoms

------------------------------

a. Does the Veteran have more than one mental disorder diagnosed?

[ ] Yes [X] No

4. Occupational and social impairment

-------------------------------------

a. Which of the following best summarizes the Veteran's level of

occupational

and social impairment with regards to all mental diagnoses? (Check only

one)

[X] Occupational and social impairment with occasional decrease in work

efficiency and intermittent periods of inability to perform

occupational tasks, although generally functioning satisfactorily,

with normal routine behavior, self-care and conversation

b. For the indicated level of occupational and social impairment, is it

possible to differentiate what portion of the occupational and social

impairment indicated above is caused by each mental disorder?

[ ] Yes [ ] No [X] No other mental disorder has been diagnosed

c. If a diagnosis of TBI exists, is it possible to differentiate what

portion

of the occupational and social impairment indicated above is caused by

the

TBI?

[ ] Yes [ ] No [X] No diagnosis of TBI

SECTION II:

-----------

Clinical Findings:

------------------

1. Evidence review

------------------

In order to provide an accurate medical opinion, the Veteran's claims

folder

must be reviewed.

a. Medical record review:

-------------------------

Was the Veteran's VA e-folder (VBMS or Virtual VA) reviewed?

[X] Yes [ ] No

Was the Veteran's VA claims file reviewed?

[X] Yes [ ] No

 [ ] Yes [X] No

2. History

----------

a. Relevant Social/Marital/Family history (pre-military, military, and

post-military):

Mr. XXXXX was born in Corpus Christi, TX and raised in TX and NV.

His parents never divorced. Mr. XXXXX has no siblings and has an

excellent relationship with his parents.

Mr. XXXXX's first marriage lasted from 2003-2005 and his

second

from 2007-2010. He remarried in 2010 and described his current

relationship as "rocky." Mr. XXXXX has four children and

described

the relationship with his children as also "rocky." He

currently lives

with his parents in XXXXX, NV. Income sources include the GI Bill and

current service-connection.

Mr. XXXXX enjoys target practice every couple of months. He rarely

socializes.

 

b. Relevant Occupational and Educational history (pre-military, military,

and

post-military):

Veteran completed a GED in 2003. Veteran noted that he was diagnosed

with Attention Deficient Disorder as a child.

Mr. XXXXX joined with the National Guard in 2004 and is currently

enlisted. MOS include infantry (11B), combat engineer (21B) and

military police (21B). Mr. XXXXX reported exposure to combat fire

(small arms, mortars, rockets, RPGs) in Afghanistan from 2011-2012.

His current rank is E-5.

c. Relevant Mental Health history, to include prescribed medications and

family mental health (pre-military, military, and post-military):

Interim Mental Health History:

Mr. XXXXX and his wife currently participate in marital counseling

at the XXXXX Vet Center. Mr. XXXXX also participates in individual

therapy with Dr. Krogh and group therapy targeted at PTSD symptoms.

Mr. XXXXX is also followed by Dr. Pai for psychiatric medication

management.

CPRS lists active medications as:

AMITRIPTYLINE TAB 50MG

PRAZOSIN CAP,ORAL 1MG

HydrOXYzine PAMOATE CAP,ORAL 25MG

GABAPENTIN CAP,ORAL 300MG

METHOCARBAMOL TAB 500MG

LAMOTRIGINE TAB,ORAL 25MG

DICLOFENAC TAB,EC 75MG

MORPHINE TAB,SA 15MG

-----------------------------------------------------------------------

--------------------

PTSD Symptoms:

Intrusive Thoughts - Mr. XXXXX reported intrusive thoughts

regarding stressor #1 on a weekly basis.

Sleep/Nightmares - Mr. XXXXX reported nightmares that occur on a

weekly basis.

Dissociative reactions - Denied.

Psychological/Physiological Reactions - Anxiety, heart palpitations

And perspiration.

Avoidance - Veteran tends to avoid thoughts and conversations

Regarding combat experience.

Difficulty Remembering - Denied.

Distorted expectations/beliefs/blame - Chronic self-blame and

suspiciousness.

Persistent negative emotion - Chronic anger.

 

Loss of Interest - Rarely participates in hobby activities.

Distant/Emotionally Numb - Rarely socializes.

Irritability - Irritability on a daily basis.

Self-destructive/reckless - Denied.

Hypervigilance/Startle - Mr. XXXXX often scans for environmental

threats and is easily startle by sudden noises.

Difficulty Concentrating - He has difficulty concentrating on mundane

tasks.

-----------------------------------------------------------------------

--------------------

d. Relevant Legal and Behavioral history (pre-military, military, and

post-military):

Veteran reported legal problems for failure to comply with a court

order.

e. Relevant Substance abuse history (pre-military, military, and

post-military):

Alcohol:

Pre military: Rarely.

During Military: Weekend binge drinking.

Post Military: Three beers/week.

 

3. Stressors

------------

a. Stressor #1: Exposure to combat fire.

Does this stressor meet Criterion A (i.e., is it adequate to support

the diagnosis of PTSD)?

[X] Yes [ ] No

Is the stressor related to the Veteran's fear of hostile military

Or terrorist activity?

[X] Yes [ ] No

Is the stressor related to personal assault, e.g. military sexual

trauma?

[ ] Yes [X] No

4. PTSD Diagnostic Criteria

---------------------------

Please check criteria used for establishing the current PTSD diagnosis. Do

not mark symptoms below that are clearly not attributable to the criteria A

stressor/PTSD. Instead, overlapping symptoms clearly attributable to other

things should be noted under #6 - other symptoms. The diagnostic criteria

for PTSD, referred to as Criteria A-H, are from the Diagnostic and

 

Statistical Manual of Mental Disorders, 5th edition (DMS-5).

Criterion A: Exposure to actual or threatened a) death, b) serious

injury,

c) sexual violatrion, in one or more of the following ways:

[X] Directly experiencing the tramuatic event(s)

[X] Witnessing, in person, the traumatic event(s) as they occurred to

others

 

Criterion B: Presence of (one or more) of the following intrusion

symptoms

associated with the traumatic event(s), beginning after the

traumatic event(s) occurred:

[X] Recurrent, involuntary, and intrusive distressing memories of the

traumatic event(s).

[X] Recurrent distressing dreams in which the content and/or affect of

the dream are related to the traumatic event(s).

[X] Intense or prolonged psychological distress at exposure to

internal

or external cues that symbolize or resemble an aspect of the

traumatic event(s).

[X] Marked physiological reactions to internal or external cues that

symbolize or resemble an aspect of the traumatic event(s).

Criterion C: Persistent avoidance of stimuli associated with the

Traumatic event(s), beginning after the traumatic events(s) occurred,

as evidenced by one or both of the following:

[X] Avoidance of or efforts to avoid distressing memories, thoughts,

Or feelings about or closely associated with the traumatic event(s).

[X] Avoidance of or efforts to avoid external reminders (people,

places, conversations, activities, objects, situations) that

arouse distressing memories, thoughts, or feelings about or closely

associated with the traumatic event(s).

Criterion D: Negative alterations in cognitions and mood associated with

the traumatic event(s), beginning or worsening after the

traumatic event(s) occurred, as evidenced by two (or more)

of the following:

[X] Persistent and exaggerated negative beliefs or expectations about

oneself, others, or the world (e.g., "I am bad,: "No one

can be trusted,: "The world is completely dangerous,: "My whole

nervous system is permanently ruined").

[X] Persistent, distorted cognitions about the cause or consequences

Of the traumatic event(s) that lead to the individual to blame

himself/herself or others.

[X] Persistent negative emotional state (e.g., fear, horror, anger,

guilt, or shame).

[X] Markedly diminished interest or participation in significant

activities.

[X] Feelings of detachment or estrangement from others.

Criterion E: Marked alterations in arousal and reactivity associated with

the traumatic event(s), beginning or worsening after the

traumatic event(s) occurred, as evidenced by two (or more)

of the following:

[X] Irritable behavior and angry outbursts (with little or no

provocation) typically expressed as verbal or physical aggression

toward people or objects.

[X] Hypervigilance.

[X] Exaggerated startle response.

[X] Problems with concentration.

[X] Sleep disturbance (e.g., difficulty falling or staying asleep or

restless sleep).

Criterion F:

[X] Duration of the disturbance (Criteria B, C, D, and E) is more than

1 month.

Criterion G:

[X] The disturbance causes clinically significant distress or

impairment in social, occupational, or other important areas of

functioning.

Criterion H:

[X] The disturbance is not attributable to the physiological effects

of

a substance (e.g., medication, alcohol) or another medical

condition.

5. Symptoms

-----------

For VA rating purposes, check all symptoms that apply to the Veterans

diagnoses:

[X] Depressed mood

[X] Anxiety

[X] Suspiciousness

[X] Panic attacks that occur weekly or less often

[X] Chronic sleep impairment

[X] Disturbances of motivation and mood

[X] Difficulty in establishing and maintaining effective work and social

relationships

6. Behavioral Observations

--------------------------

Mr. XXXXX arrived on time for his appointment. Grooming and hygiene

Were adequate. He was alert and cooperative throughout the examination.

Expressive speech was fluent; thought processes were logical. Veteran

described his mood as "frustrated and eager to get out of here";

affect was congruent with his mood state. He denied any suicidal/homicidal ideation,

plan, or intent. There were no indications of delusions, hallucinations or

other signs of frank psychosis. Insight and judgment were intact.

 

7. Other symptoms

-----------------

Does the Veteran have any other symptoms attributable to PTSD (and other

mental disorders) that are not listed above?

[ ] Yes [X] No

8. Competency

-------------

Is the Veteran capable of managing his or her financial affairs?

[X] Yes [ ] No

9. Remarks, if any

------------------

Veteran completed the PCL-5, a self-report measure of PTSD and obtained a

56.

On the BDI-II, a self-report measure of depression, Veteran obtained a

34, suggesting severe depression. The BAI is a self-report measure of

anxiety; his score of 20 indicates moderate anxiety.

Veteran currently meets DSM 5 criteria for PTSD and currently

Participates in relevant mental health treatment at the XXXXX VAMC.

NOTE: VA may request additional medical information, including additional

examinations if necessary to complete VA's review of the Veteran's

application. Income sources include the GI Bill and current service-connection. Patient enjoys target practice every couple of months. He rarely socializes.

 

b. Relevant Occupational and Educational history (pre-military, military,

and post-military):

Veteran completed a GED in 2003. Veteran noted that he was diagnosed

with Attention Deficient Disorder as a child.

Patient joined with the National Guard in 2004 and is currently

enlisted. MOS include infantry (11B), combat engineer (21B) and

military police (21B). Patient reported exposure to combat fire

(small arms, mortars, rockets, RPGs) in Afghanistan from 2011-2012.

His current rank is E-5.

 

c. Relevant Mental Health history, to include prescribed medications and

family mental health (pre-military, military, and post-military):

Interim Mental Health History:

Patient and his wife currently participate in marital counseling

at the XXXXX Vet Center. Patient also participates in individual

therapy with Dr. XXX and group therapy targeted at PTSD symptoms.

Patient is also followed by Dr. XXX for psychiatric medication

management.

 

CPRS lists active medications as:

AMITRIPTYLINE TAB 50MG

PRAZOSIN CAP,ORAL 1MG

HydrOXYzine PAMOATE CAP,ORAL 25MG

GABAPENTIN CAP,ORAL 300MG

METHOCARBAMOL TAB 500MG

LAMOTRIGINE TAB,ORAL 25MG

DICLOFENAC TAB,EC 75MG

MORPHINE TAB,SA 15MG

-----------------------------------------------------------------------

--------------------

PTSD Symptoms:

Intrusive Thoughts - Patient reported intrusive thoughts

regarding stressor #1 on a weekly basis.

Sleep/Nightmares - Patient reported nightmares that occur on a

weekly basis.

Dissociative reactions - Denied.

Psychological/Physiological Reactions - Anxiety, heart palpitations

And perspiration.

Avoidance - Veteran tends to avoid thoughts and conversations

Regarding combat experience.

Difficulty Remembering - Denied.

Distorted expectations/beliefs/blame - Chronic self-blame and

suspiciousness.

Persistent negative emotion - Chronic anger.

Loss of Interest - Rarely participates in hobby activities.

Distant/Emotionally Numb - Rarely socializes.

Irritability - Irritability on a daily basis.

Self-destructive/reckless - Denied.

Hypervigilance/Startle - Patient often scans for environmental

threats and is easily startle by sudden noises.

Difficulty Concentrating - He has difficulty concentrating on mundane

tasks.

-----------------------------------------------------------------------

--------------------

d. Relevant Legal and Behavioral history (pre-military, military, and

post-military):

Veteran reported legal problems for failure to comply with a court

order.

 

a. Stressor #1: Exposure to combat fire.

Does this stressor meet Criterion A (i.e., is it adequate to support

the diagnosis of PTSD)?

[X] Yes [ ] No

Is the stressor related to the Veteran's fear of hostile military

Or terrorist activity?

[X] Yes [ ] No

Is the stressor related to personal assault, e.g. military sexual

trauma?

[ ] Yes [X] No

4. PTSD Diagnostic Criteria

---------------------------

Please check criteria used for establishing the current PTSD diagnosis. Do

not mark symptoms below that are clearly not attributable to the criteria A

stressor/PTSD. Instead, overlapping symptoms clearly attributable to other

things should be noted under #6 - other symptoms. The diagnostic criteria

for PTSD, referred to as Criteria A-H, are from the Diagnostic and

 

Statistical Manual of Mental Disorders, 5th edition (DMS-5).

 

Criterion A: Exposure to actual or threatened a) death, b) serious


#22 usdart

 
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Posted 27 May 2014 - 10:24 AM

WARNING, LONG POST

I'll go ahead and clear the air here; I know this is going to upset a lot of Veterans that have been seeking a strong rating and have been denied. My apologies, I'm not trying to sound ungrateful here.

Here's the situation:
I am a full-time educator who has been working for several months (successfully). I was at a 50% PTSD rating for the the past four years, but recently went in for my re-evaluation. Terrified of the outcome and possible reduction, I went in prepared; I had my list of symptoms, I wrote down the worst days I've had recently, and I was open and honest with the evaluator. Today, I received notice that my rating for PTSD and depression has been raised to 100%.

The money would be nice. I have a family and am expecting another child soon, but I still don't want this rating.
I need to work. Structure and implied hierarchies rule my life. I have a routine that I daily and any deviation from this ruins the entire day. If they took my job away, I would genuinely lose it. . .

Here are the reasons I want to lose this rating:
1. I'm terrified of losing my routine and know full well that a new one wouldn't be good for me. The paycheck from the VA would be more than I could make at my job (teachers have a salary ladder) until about five years from now. If I have this much money coming in, I'll get stuck in a rut that I will never break free from.

2. I'm terrified about coming to grips with my condition. Yes, I have some problems. No, I don't think they are severe enough to warrant this decision. I'm able to work. I need to work. If I don't contribute something to the world then I'm lost. I know Vets who cannot function in daily society, and I'm not one of them. I don't want to take away from the people who really need this benefit.

3. I'm worried what others think. Yes, I know it's shallow, but I spend the majority of my time analyzing others. One of my conditions is that I've lost the ability to respond well socially; I'm emotionally numb unless I'm chemically altered. With a 50% rating, my friends, family (and possibly employers) think I've got a "little baggage." With 100%, I doubt they could ever look at me the same. Those that love me will question whether I'm going to do something drastic, and those who don't will judge me and may think I'm faking.

I'm grateful that the VA took the time and genuinely listened to me, but I think they're overdone it. Can anyone tell me how to rectify this situation? I don't want benefits I don't believe I'm entitled to. I don't want the VA to think I inflated my condition for profit, and I don't want to lose the one thing that keeps me from crawling into a hole (job).

How long can i continue to work before they come after me? I'd at least like to finish up the school year. If I break contract (even though it would be for good reason) I would really destroy my chances of ever teaching again. It's a small town, who would hire me after that?

Thanks for all the help.

I am 100% P&T for PTSD and had the same types of concerns so I called Human Resources. I was told I do not have to disclose my percentage and only have to say 30% or more. In addition I was told the Company has several people with 100% that ARE working. As long as you are not unemployable. So now I am in good shape financially for the first time in my life. No more stressing to meet the bills and spouse arguing about money is a big stress reliever and is helping with my mental health.



#23 vet201060

 
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Posted 25 September 2014 - 11:25 PM

If you read the rating for mental condition and also the CFR that goes along with them then you can still work.  It is based on what is expected of the average person.  However, if you work they may decide to reduce you if you dont show the same symptoms and show improvement.  It does not say you have to quit working at all.  I am having a hard time but I still continue working with a 100% rating. I just make sure and tell them the truth when they ask me questions.  They know that I work so it is untrue to say that you cant work with a 100% scheduler mental rating.







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