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Denied Ptsd?


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15 replies to this topic

#1 AFMedic09

 
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Posted 02 May 2012 - 03:20 PM

You can find the exact verbage under the "Success" forum. However, my question is this: I was denied for PTSD/depression due to no evidence of current disability. Not sc, no 0% under what they decided on. BUT on another page it says I am sc'd for adjustment disorder with depressed mood for purposes of treatment as I was diagnosed with PTSD/depression in 2001. (joined in 1999) I have never seen any diagnosis of adjustment d/o in my medical records so this must be something the c&p dr said. However, what does this mean? I have not even a 0% rating in my paperwork for this - but I can be seen for it? They gave it to me based on my C&P but denied my claim? Can anyone shine light on what their thinking is and what this means? Should I NOD? I haven't been seen except once since separating, just trying to handle life on my own. I know I need medication- this process is proof of that. I just don't understand what it means? Thanks for any help you can offer.

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#2 JT24usn

 
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Posted 02 May 2012 - 05:09 PM

Sounds like treatments for medical purposes only. Not an sc condition. This is a new thing for gulf war vets who need treatment for mental issues even if cant be seen for anything else. Don't quote me on it. Read the rating decision and see if it says for medical treatment only

Edited by T8r, 02 May 2012 - 05:49 PM.


#3 11cvolley

 
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Posted 02 May 2012 - 05:26 PM

If you're truly suffering from PTSD get treatment asap. Find out what your treating doctors are calling it if not PTSD. Work on your stressor letter and gather evidence. You should start PTSD treatment then file NOD.

#4 john999

 
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Posted 02 May 2012 - 06:07 PM

It seems to me the VA is saying you do not have a current DX of PTSD or Depression because the VA can't find any current evidence of your having it. Read up on symptoms of PTSD and see if what you told the VA matches those symptoms. If you told them that every time you hear a loud noise you flashback to combat then the VA is just trying to play a game with you. Do you have any combat medals or badges? You need the stressors and you need the current symptoms. The stressors have been relaxed but what you get is the kind of crap you got with the VA pretending they don't see symptoms.

John

#5 11cvolley

 
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Posted 02 May 2012 - 06:28 PM

It isn't just VA doctors but all doctors. They're funny on what they call your condition. Some might call it PTSD, anxiety, schizophrenia, or some other condition.

Do an online quiz to see if you have PTSD. Take that to your mental health doctor and say, "see this test? I think I have PTSD." You have to remember it is important to get the correct diagnoses. PTSD or not your number one goal should be treatment. Hang in there.

#6 AFMedic09

 
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Posted 02 May 2012 - 08:46 PM

I was diagnosed with PTSD and depression in the military. Was on Prozac and went through years of therapy sessions. Since separating I have had to work full time, and over time as the economy is terrible & my ex doesn't pay child support so it's all on me. I am goint to start therapy again. Having more frequent bad days. I told the C&P dr. that I can't sit with my back to the door, I have had panic attacks due to boxes on side of road (WHO DOES THAT?!?!?!?!!!) etc. The letter says they see where I was diagnosed with PTSD in the military, but that basically since I'm not being treated currently they wont SC. Not even 0%? But they sc'd for purposes of treatment. I don't know. I am going to start seeing a psych. and start complaining instead of carrying all of this around in me..my family will appreciate it. and then I will NOD. I just don't know why they didn't give me 0%. THey gave me 0% for restless leg syndrome, and I'm not being treated for that currently. (makes no sense what they sc'd and what they didn't) I was in therapy for YEARS. I have a combat ribbon. My diagnosis throughout treatment was PTSD & depression.

#7 carlie

 
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Posted 03 May 2012 - 01:03 AM

You can find the exact verbage under the "Success" forum.


AF - Below is what you posted over in the Success forum.
"Service connectsion for adjustment disorder with depressed mood for the purpose of establishing eligibility to treatment.
A determination of service connection under 38 U.S.C. 1702 is for the purpose of providing eligibility for hospital and medical treatments for veterans of WWII, Korean Conflict, or Vietnam era: or for Gulf War veterans who develop an active psychosis or any active mental illness during or within two years from the daate of separation from such service or within two years of the end of the war period, whichever is earlier. The veteran was discharged on November 16, 2009. A psychosis/mental illness was first diagnosed on March 6, 2001 while you were on active uty. Entitlement to treatment is established because a psychosis/mental illness was diagnosed within the required period of time. Service connection for the purpose of establishing eligibility to treatment is established."

However, my question is this: I was denied for PTSD/depression due to no evidence of current disability.

AF - The above does not even specifically address an anxiety (PTSD) or mood disorder (MDD).
It only states a "psychosis/mental illness".
So far, from what I've read posted, you have not received a decision denying "PTSD/depression"
Please, get your rating decision and post exact what is on it, that pertains to mental health under:
ISSUES
EVIDENCE
REASONS

Not sc, no 0% under what they decided on.

BUT on another page it says I am sc'd for adjustment disorder with depressed mood for purposes of treatment
as I was diagnosed with PTSD/depression in 2001. (joined in 1999)
AF - Post exactly what is stated on the decision.
Another thing to keep in mind (this is the way I see it) -
they have SC'd a mental health condition (other than eating disorder) for
"the purpose of establishing eligibility to treatment".
Again, PTSD has not been denied BUT at this point I don't even see where you really need to argue
for PTSD.
To me - the objective goal is to get SC'd for a mental health disorder( if you have one that is
related to active duty) and receive your benefits of medical treatment and compensation for it.
I have taken on the mind set of - it does not matter if they grant under PTSD / MDD / Panic Disorder /
etc ...
They have already stated that:
"A psychosis/mental illness was first diagnosed on March 6, 2001 while you were on active uty".
IMO - this will need to be developed more and it's real important to see exactly everything
the decision states about it.

I have never seen any diagnosis of adjustment d/o in my medical records so this must be something the c&p dr said.
However, what does this mean?
AF - If your C&P was done at a VAMC - go there to Release Of Information (ROI) and get a
copy of the C&P, in fact get copies of all the C&P's you've had while waiting on this decision.

I have not even a 0% rating in my paperwork for this - but I can be seen for it?
They gave it to me based on my C&P but denied my claim?
Can anyone shine light on what their thinking is and what this means?
Should I NOD? I haven't been seen except once since separating, just trying to handle life on my own.
I know I need medication- this process is proof of that.

AF - I would not do anything further until you can post the answers and members can help out on this.
What I would do is start making some VAMC appointments for mental health care (and medications if needed)
ASAP.
JMHO - carlie



#8 carlie

 
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Posted 03 May 2012 - 01:23 AM

I was diagnosed with PTSD and depression in the military. Was on Prozac and went through years of therapy sessions.

AF - do you have copies of the above from your SMR/STR's?
Are they listed in the evidence section of the rating decision?
Is the above addresses any where in the rating decision?

Since separating I have had to work full time, and over time as the economy is terrible & my ex doesn't pay child support so it's all on me.

AF - if your Migraines are not, "very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability" (don't your ability to earn a living) , you might not get higher than the 30 percent that
was granted.

The VA is not concerned with the economy or your ex not paying child support as it does not
have any relationship to claims for benefits.
In the recent grant of 40 percent, at least VBA will provide additional compensation cash for your dependents.
Be sure to file for it properly, if you haven't yet.

I am goint to start therapy again. Having more frequent bad days.
AF - You have established eligibility for mental health care - make some appointments.

I told the C&P dr. that I can't sit with my back to the door, I have had panic attacks due to boxes on side of road (WHO DOES THAT?!?!?!?!!!) etc.
AF - Get a copy of the C&P.

The letter says they see where I was diagnosed with PTSD in the military, but that basically since I'm not being treated currently they wont SC.
AF - I don't see anywhere yet exactly what the decision states. Please post it.

Not even 0%? But they sc'd for purposes of treatment. I don't know. I am going to start seeing a psych. and start complaining instead of carrying all of this around in me..my family will appreciate it. and then I will NOD. I just don't know why they didn't give me 0%.
AF - I wouldn't just file a hap-hazard NOD in response.

THey gave me 0% for restless leg syndrome, and I'm not being treated for that currently. (makes no sense what they sc'd and what they didn't)

I was in therapy for YEARS. I have a combat ribbon. My diagnosis throughout treatment was PTSD & depression.
AF - where were you in therapy at? What exactly is your "combat ribbon" and who and when did the diagnosis
for PTSD & Depression ?
JMHO - carlie



#9 AFMedic09

 
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Posted 03 May 2012 - 05:43 AM

Carlie-
My SMR list PTSD and Depression under chronic illnesses. This was my diagnosis while active duty. My letter from VA states under reason for denial of PTSD/Depression:
Denial Reason: The evidence does not show a current diagnosed disability.
Expanation: We received your medical evidence from ********** **********, ********** ******, and *********** VA Medical Center, which discusses the symptoms of your medical condition. The examiner stated that you currently do not have a diagnosis of any mental disorders. There is no objective evidence of functional impairment found socially, occupational, or with activity of daily living due to a mental disorder.

I am not being treated currently, but I DO have symptoms. I have missed days of work and so much so that I was repremanded for it. (I told the C&P examiner this!!!)

My SC'd conditions according to my letter are as follows:
1) Migraines: 30% 2)TVT Sling: 20% 3)Mild dry eyes:0% 4) Allergic rhinitis:0% 5) Anemia:0% 6) Scar:0% 7) Restless leg syndrome bilaterally:0% Your overalll or combined rating is 40%. We do not add the individual percentages of each condition to determine youru combined rating. We use a combined rating table that considers the effect from the most serious to the least serious conditions.

Now there are no more sc'd conditions. It goes right into what was deferred for further C&P's. (Prolapsed bladder, cyctocele, rectocele)

However, In the second part of the packet it states: REASON FOR DECISION. Lists all of the above 7 SC'd conditions and why they rated as they did. THEN there is #8 SERVICE CONNECTION FOR ADJUSTMENT DISORDER WITH DEPRESED MOOD FOR THE PURPOSE OF ESTABLISHING ELIGIBILITY TO TREATMENT
It goes on to read: Service connection for adjustment disorder with depressed mood for the purpose of establishing eligibility to treatment.
A determination of service connection under 38 U.S.C. 1702 is for the purpose of providing eligibility for hospital and medical treatments f...


as I posted in 'Success" forum. This is why I am confused. It is not even listed under SC'd conditions in the break down. Not even listing it for 0%. However, in this part of the packet it is listed. So all I gather is they will treat me for it because I was diagnosed in the military (which should SC me as far as I know..at LEAST to 0% - right?) "Service connection for the purpose of establishing eligibility to treatment is established" -- isn't that what 0% means?
If so, why isn't this listed on the break down page under "Medical Description, Percent Assigned, Effective Date" ?

The VA I am located near has a 700 person waiting list. I was told "good luck", and they recommended I drive 2 hrs to the other VA which might have a shorter waiting list. I am going to start seeing a private psych. and get on some meds.

As for my migraines, I am not unhappy with my rating. I just wanted to be sure I wasn't simply rated for ocular migraines because I have classic migraine headaches and ocular migraines which are completely debilitating. However, like you said - I am sc'd properly, and I don't complain about that. None of the things I was "denied" for state they found no evidence to support them, just that they denied because I am not being treated currently. Like I said - not currently being treated for restless leg either, but they gave me 0% for that.

Thank you for your time. I hope I explained my confusion a little better....

Edited by AFMedic09, 03 May 2012 - 05:45 AM.


#10 Berta

 
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Posted 03 May 2012 - 06:29 AM

Carlie is right-this needs to be developed more-

An inservice psychosis can be service connected as a chronic presumptive condition under 38 CFR 3.307 if all other conditions of the regulations are met.

But one of the conditions is that it must have been manifested at least at a 10% disabling level within the first year after service.

Did the VA specifically refer to any consideration of 38 CFR 3.307 in the decision?


Can you scan and attach the entire decision here (as to their reasons and basis) Cover the personal stuff first.

38 CFR 3.307 and 309 contain the info that might help you utilize this regulation to your advantage.

However many vets often need to obtain buddy statements as to their symptoms within that first year after service ,unless they have medical evidence within one year after discharge to warrant the regs to kick in as a presumptive chronic condition, which ';psychosis ' is, as found within the chronic disabilities listed in 38 CFR 3.309.

For example I was reading a POW claim award the other day.

The specific POW presumptives are within the above regs.

The veteran claimed frostbite residuals due to his interment at a POW camp,unheated in the dead of winter.

Buddy statements from his family members , as to his symptoms when he was liberated, as well as other medical evidence warranted the award for frostbite residuals.

On the other hand he tried to prove he had DMII due to nutritional deficiencies that are certainly problems POWs can develop that can affect the entire metabolism system.

His buddy statements on that part of his claim as well as a strong IMO didnt help him there.

I am trying t prepare a little more info on "buddy statements' to put here or maybe for a SVR show- as we often consider them to support stressors, but they can go a long way too ,in proving chronic presumptives in 38 CFR 3.307, 3.309 as well.

Do you have a vet rep helping you?









hey have already stated that:
"A psychosis/mental illness was first diagnosed on March 6, 2001 while you were on active uty".
IMO - this will need to be developed more and it's real important to see exactly everything
the decision states about it.

Edited by Berta, 03 May 2012 - 06:36 AM.


#11 Gridsmasher11

 
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Posted 03 May 2012 - 07:20 AM

AF, don't give up..They denied my PTSD 3 times saying there was no evidence of me currently having it..It took a years worth of clinical notes from a VA phsychiatrist stating that I had it plus attending therapy for me to get a new C&P exam....Shortly thereafter I was awarded 70% for PTSD........SO go to your VA primary care doc and request a mental health exam, then attend the therapy sessions...Once you have seen the shrink a few times get your notes and submit them.....I think that you really need to establish that you still have it.But remember that it has to be diagnosed by a VA mental health professional...................Good luck and keep trying......Grid

#12 AFMedic09

 
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Posted 03 May 2012 - 10:12 AM

Thank you Grid. My local VA has a 700 person waiting list, but I am not sure if that includes Mental Health treatment...I will call now and find out.

#13 Gulfvet45

 
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Posted 03 May 2012 - 11:33 AM

I was diagnosed with PTSD and depression in the military. Was on Prozac and went through years of therapy sessions.
Like others have said you need to show this, but you need to address in your NOD the fact that the examiner did not address this fact.
An adequate exam is one that is based on a complete review of the veteran record.

Having more frequent bad days. I told the C&P dr. that I can't sit with my back to the door, I have had panic attacks due to boxes on side of road (WHO DOES THAT?!?!?!?!!!) etc.
Put this in the NOD and send in the copies of the dab boy reports from your job too.

The letter says they see where I was diagnosed with PTSD in the military, but that basically since I'm not being treated currently they wont SC. Not even 0%? But they sc'd for purposes of treatment. I don't know. I am going to start seeing a psych.

Mental health treatment is open to anyone free even if you are not SC.

I saw you had 30% for headaches too to get a 50% rating you need 2 or more per month that will require you to seek bed rest for a long time and a proof you lost time from work due to them.(income)



#14 AFMedic09

 
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Posted 03 May 2012 - 03:15 PM

Berta - I will try to cover and scan my entire letter so that you can see what I am talking about. Will try to do this on Saturday as I am working until tomorrow morning, and have to be back in at 4pm. Thank you for your time.

#15 carlie

 
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Posted 03 May 2012 - 06:35 PM

Gulfvet45,
You posted,
"Mental health treatment is open to anyone free even if you are not SC."

In many situations I would be in disagreement with this.

Do you have a link to support the above?

#16 john999

 
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Posted 04 May 2012 - 10:08 AM

For a vet to get the benefit of the chronic psychosis manifested within one year of discharge you need to get you butt to the nearest VA and get evaluated and/or admitted. I was so dizzy that I actually went to the VAMC right after I was discharged to get some help. I got admitted and got zero help. However, it showed on my record that I was "treated" and "DX'ed" with a residual psychosis. I had no plan and it was all an accident. If I had waited two years to file my claim I would have been out of luck. Things were a lot different back in 1971, but still the best thing a vet can do is to go to the VA for complete physical upon discharge. This could mean the difference between SC and no SC. I got just 10% but based on that 30 years later I got TDIU.




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