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Question After Receiving Copy Of Ptsd C & P


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#1 USMC5811

 
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Posted 23 July 2012 - 05:44 PM

How much weight does a C&P exam/report have in the overall rating by VA? - I do realize that is is not the only thing they consider. The reason I ask this is because the local VA mental health doctor/therapist that has been treating my husband did diagnose him with PTSD that conforms to DSM-IV criteria but not to the extreme (both in GAF Score and when it comes to Occupational and Social Impairment) that the C&P examiner did. Please understand I'm not complaining about the C&P report as I feel it is a more accurate representation of my husbands current (to this day)problems, having been married to him for over 20 years I knew him very well before and after combat.

Diagnostic Summary

Does the veteran have a diagnosis of PTSD that conforms to DSM-IV criteria based on today's evaluation? Yes

Current Diagnoses

Diagnosis #1: Post Traumatic Stree Disorder/Chronic, Moderate to Severe Axis 1
Diagnosis#2 Panic Disorder with Agoraphobia - Axis 1
Diagnosis#3 Depressive Disorder Not Otherwise Specified - Axis 1

GAF score: 35
Comments: Major impairment in several areas

Does the veteran have more then one Mental disorder diagnosed? Yes

Occupational and social impairment

Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgement, thinking and/or mood. (Is checked)

Is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder?

PTSD: 70%, Panic Disorder with Agorophobia 10% and Depressive Disorder NOS: 20%

In the section for Stressors:

Does this (there are several stressors listed - all combat related that I would rather not post the details ) meet Criterion A - Yes
Are the stressors related to the Vet's fear of hostile military or terrorist activity? Yes

Which stressor contributed t othe Veterans PTSD diagnosis? All the stressors are checked.

Symptoms (the following are checked):

Depressed mood, anxiety , suspiciousness, panic attacks more then once a week, chronic sleep impairment, difficulty in understanding complex commands, disturbances of motivation and mood, Difficulty in establishing and maintaining effective work and social relationships, Difficulty in adapting to stressful circumstances, including work or worklike setting, impaired impulse control, such as unprovoked irritability with periods of violence, disorientation to time and place, intermittent inability to perform activies of daily living.

Other Symptoms:

Other symptoms are listed for each listed Disorder but I believe they are a bit personal.

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

Yes.

Remarks: A diagnosis of PTSD is made. It has been determined that the veteran's claimed stressors are related to the veterans fear of in-service hostile military or terrorist activity. Rationale: His stressors/traumas are eligible for PTSD definition of traumas and he further met all of the other criteria of DSMIV for PTSD.


He had gone to a Civilian Psych (via Tri-Care as he's retired 22 years) over a year ago - that Dr was the first to diagnos him with PTSD - had to threaten him with leaving (which I would NEVER do....no matter how bad it gets but at the time he did not need to know this) to get him to go . He's been seeing a VA therapist since that time who also diagnozed him with PTSD - her initial exam of him is much like the above....but her recents comments have just been things like: has much less anger, clear speach, calm, coherent, Pt aware of person, place, time and situation. Casually dressed and adequately groomed, in fair mood with congruent effect. Complexity of Illness/Level of Impairment: moderate and stable at this time. YET they increased the doseage amount of medication that had been perscribed. To be honest....I personally have not seen much change for the better since he has been going to therapy....the medication has helped with his anger/outbursts a little but other things have remained the same or gotten worse:(

Looking at the VA's rating table for MH problems - I would think he would get a 70% rating if all they considered was the C&P........but with some of the things his current therapist is stating I think it might be lower.

To be perfectly honest though.....I just wish I could have my husband back to his former self.

Thanks in advance for any thoughts or answers to my questions.

Edited by USMC5811, 23 July 2012 - 05:45 PM.


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#2 john999

 
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Posted 23 July 2012 - 06:10 PM

I think he will get 100% and I hope it is permanent and total. A GAF of 35 means he is at a very low level of functioning. Denial is one of the major symptoms of ptsd.

#3 Berta

 
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Posted 24 July 2012 - 09:11 AM

I agree- as that was my husband's SC PTSD rating with GAF scores from 34 to 26 for PTSD and I think with the agoraphobia diagnosed , the VA should consider him for the Housebound SMC award too but they might not and he could appeal that.



I certainly know it is not easy to be in your position of supporting your husband while often perhaps becoming a victim of his PTSD yourself.
VA willingly gave us family counseling but it was ineffective for many reasons- too personal to say why.

Years ago the spouse of a PTSD vet started a PTSD spouses group and managed to get the local VAMC to allow the group to meet in the VA community room. It seemed to help many spouses who attended the initial meetings to at least know they were not alone with their problems and to find others who completely understood their situation.
I was asked to join and went to 2 meetings but it was then suggested to me that,since my husband had died, I was no longer a PTSD spouse apropriate for this group.

Many there had never even shared with anyone before, how PTSD was affecting them as a spouse. Some cried in shame for what they had been putting up with that they had never told anyone of.
I was also a former Vet center PTSD combat group volunteer and felt that experience would have helped this group as somehow as I lived in two separate worlds regarding PTSD. And still do.

The traumatic pain of a stressor, to the veteran is real, often catastrophic,.and certainly not the veteran's fault.
But that goes for many PTSD spouses as well.


I certainly hope you have a good support system ..and maybe there is a group like this in your locale, there are also PTSD spouse groups on the internet.

Edited by Berta, 24 July 2012 - 09:13 AM.


#4 USMC5811

 
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Posted 24 July 2012 - 11:52 AM

Thank you very much for your replies John and Berta. Thank you also Berta for your insight and understanding, no doubt you of all people understand the pain, sadness etc of watching a wonderful man fight the demons of war that haunt him - its such a helpless feeling for a spouse. His current therapist did reach out to me in regards to a wife (of veterans with PTSD) support group, providing me with a phone number to call, but I have not yet called. Maybe someday I will....... I am a veteran also and am dealing with my own demons. We are muddling through all this.....

Believe it or not...he is still working. He had to give up his business a few years back because of not being able to deal with people or be around people without the rage rearing its ugly head and other symptoms of his illness. Something that had to be done and I'm glad for his sake and others around him (their safety), that he reluctantly gave in. He now works delivering small packages...he's by himself 97% of the work day, but that 3% is what has me worried everyday. I think him working...is something he needs but to be honest we also need to survive financially...even though it takes him upwards of 2 hours to get ready for work and get out there - he says it gives him a purpose in life.:( Other then work and dr appointments...he would not leave the house..stopped fishing or doing anything that he usta enjoy:( I got him a German Shepherd puppy a couple of years ago which has been the BEST thing for him...he takes her for short walks and spends alot of time with her on our property, they are both very bonded....has helped his moods just having her by his side. Sometimes I'm actually jealous of her and his attention to her:)

Thanks again for the responses...sorry I rambled...

#5 Berta

 
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Posted 24 July 2012 - 12:54 PM

He is still Working?

I need to change my opinion-

Employment will impact on his VA compensation rating and certainly my idea of 100% plus perhaps SMC potential is now
incorrect , knowing he can work.

I do suggest that he go over the links here to CRDP and CRSC regarding those programs and he might be eligible for one of them.




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