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      How to get your questions answered. A few observations, and requests of all members. All folks who come here are volunteers who do this on their own time and their own dime.To avoid burning out our best contributors please follow these guidelinesf you are reading a post and it reminds you of a question you want to ask, start a new topic, if you place your question in someone thread it will be difficult to distinguish your question from the original poster, you will get better results posting a new topic with your question. 1. Before Posting please do a search and see if your question has already been answered. If you find the answer print it out and put it in a file to use as a reference file, I find this helpful myself. 2. If you can not find the answer and you do post a question, please print out those answers and refer to them to avoid duplicate questions. 3. Refer to the Frequently Asked Questions4. Duplicate questions will come up from time to time but the keeping them to the minimum will lighten the load on the regular volunteers.5. Respect folks privacy do not request their personal phone numbers for claims help, it is inappropriate and not why they are here.6. Keep the topics focused on veterans issues, in closing Search first Search ... Ask second.it may save a lot of time or at the very least enlighten you.
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    • A bit about Tbird and HadIt.com for those who've asked...

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

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    • VA Training and Fast Letter Forum Index

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


Question

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1. Diagnostic Summary

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

2. Current Diagnoses

a. Diagnosis #1: PTSD

Axis I

Diagnosis #2: Alcohol Dependence in remission

Axis I

b. Axis III - medical diagnoses (to include TBI):

Chronic pain, diabetes, hyperlipidemia, hypothyroidism, GERD, HTN, sleep apnea

c. Axis IV - Psychosocial and Environmental Problems (describe, if any):

Unemployment, recent death of dog

d. Axis V - Current global assessment of functioning (GAF) score:

50

3. Differentiation of symptoms

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

b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? YES

If yes, list which symptoms are attributable to each diagnosis:

The Veteran no longer drinks alcohol.

4. Occupational and Social Impairment

a. <X> Occupational and social impairment with reduced reliability and productivity

SECTION II: CLINICAL FINDINGS:

1. Evidence Review

a. <X> Claims Folder (C-file)

<X> YES

<X> Other, please describe:

Interview, CPRS and Vistaweb review

b. Was pertinent information from collateral sources reviewed? NO

2. History

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

The Veteran reported a generally normal childhood and socialization although he had few friends growing up. He was married once for 6 years and had one daughter, but divorced after his wife cheated. He was married a second time for 4 years, but divorced after his wife cheated. He has been married for the past 3 years which is doing well. He spends his days shopping, cooking, watching TV, doing yardwork, going to church, and sometimes fishing.

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

The Veteran completed the 12th grade. He completed 1.5 years of college with a 3.5 GPA in construction management, but left school when he was unemployed and unable to afford it. The Veteran worked in construction management at 2 different positions for 7 years total, leaving them for better positions, but at his 3rd position which he held for 4-5 years he was laid off as part of a downsizing maneuver. The Veteran did well and was being groomed for a VP position, but did have an argument with a client which he believes may have impacted the decision to let him go. He has been unable to find work and began collecting SSDI for PTSD in 2009.

c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military):

The Veteran first began psychiatric care in 2005 and psychotherapy last year. He currently attends group therapy and medications include prazosin and sertraline. He did participate in marital counseling during his second marriage. Family mental health history is positive for suicide and addiction.

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

One suspension in school for fighting. One Article 15 in 1996 for having a foreign national in his barracks.

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

The Veteran does not smoke. He did smoke marijuana regularly from 2000-05. The Veteran began drinking heavily following Desert Storm until 2009 and would drink 24 beers or more until passing out.

3. Stressors

a. Stressor #1: On 2/25/91 the Veteran was on guard duty at Khobar, Saudi Arabia when a SCUD landed and killed 28 soldiers and injured 250 others. The Veteran was later required to remove his protective mask to assess the possibility of chemical agents.

Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? YES

Is the stressor related to the Veteran's fear of hostile military or terrorist activity? YES

4. PTSD Diagnostic Criteria

a.

Criterion A:

<X> The Veteran experienced, witnessed, or was confronted with an event that involved actual or threateded death or serious injury, or a threat to the physical integrity of self or others.

<X> The Veteran's response involved intense fear, helplessness or horror.

Criterion B:

<X> Recurrent and distressing recollections of the event, including images, thoughts, or perceptions

<X> Recurrent distressing dreams of the event

Criterion C:

<X> Efforts to avoid thoughts, feelings or conversations associated with the trauma

<X> Efforts to avoid activities, places or people that arouse recollections of the trauma

<X> Markedly diminished interest or participation in significant activities

<X> Feeling of detachment or estrangement from others

<X> Restricted range of affect (e.g., unable to have loving feelings)

Criterion D:

<X> Difficulty falling or staying asleep

<X> Irritability or outbursts of anger

<X> Difficulty concentrating

<X> Hypervigilance

Criterion E:

<X> The duration fo the symptoms described above in Criteria B, C, and D is more than 1 month

Criterion F:

<X> The PTSD symptoms described above cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

b. Which stressor(s) contributed to the Veterans PTSD diagnosis?:

<X> Stressor #1

5. Symptoms

<X> Anxiety

<X> Chronic sleep impairment

<X> Difficulty in establishing and maintaining effective work and social relationships

<X> Difficulty in adapting to stressful circumstances, including work or a worklike setting

6. Other symptoms: NO

7. Competency

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

8. Remarks, if any

The Veteran reported symptoms consistent with a diagnosis of PTSD. He reported a stressor wich would meet diagnostic Criterion A for PTSD and is consistent with the kinds of duties expected of a service member at that time and in those circumstances. There are no pre- or post-military traumas which would account for his symptoms and his entrance physicals on 5/31/88 and 7/7/88 do not show any indications of prior psychiatric history or treatment. It is at least as likely as not that the Veteran has PTSD that was caused by or resulted from military service. The Veteran reported only mild anergia and amotivation as current symptoms of depression. He did report prior depressive episodes beginning after service in Desert Storm, but these are more likely than not manifestations of PTSD rather than a separate medical entity.

After the interview, the psychologist shook my had, thanked me for my service, and said "enjoy your retirement"

Thoughts? Thanks in Advance!

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12 answers to this question

Posted · Report post

Probably 70% and possibly TDIU. With the SSDI you should get TDIU, period. jmo

pr

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Posted · Report post

Absolutely.! TDIU.

If the SSDI award preceded the date of the claim,it is possible there would be an additional year retro to the filing date.

I dont have the reg in front of me.... will look for it and post it here....

I just hope VA is award of the SSDI award and has obtained those records.

"The Veteran was later required to remove his protective mask to assess the possibility of chemical agents."

Say what?

Sounds like a GPM (guinea pig maneuver) Geez

Maybe I misunderstood that.

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Posted · Report post

This is what I meant by the EED retro.and additional year due to SSDI.

This depends on the criteria here in M21-1MR:

M21-1, Part VI January21, 2004
Change 109


"Unemployability. Authorization will tell the veteran the form can be used to apply for a 100 percent evaluation based on individual unemployability. If evidence is submitted establishing individual unemployability due to service-connected disabilities, prepare a disability rating granting the individual unemployability.

The effective date will be the earliest date the evidence shows individual unemployability if a claim is received within 1 year from such date. Otherwise, the effective date will be the date of claim, provided that the evidence shows entitlement as of that date and the date is not prior to August 1, 1975. See 38 CFR §3.400(o). If evidence is submitted establishing individual unemployability, but because of the reduced evaluations the percentage requirements of 38 CFR §4.16 are not met, refer the claims folder to Central Office (211B) for consideration under 38 CFR §3.321(cool.gif(1). "

from:http://64.233.167.104/custom?q=cache:MZXWz1SWPHkJ:www.warms.vba.va.gov/admin21/m21_1/part6/chg109.doc+M21-1+earliest+effective+date&hl=en&ct=clnk&cd=2&gl=us&ie=UTF-8&client=pub-2090988506854078

It works in practice (if the VARO does the claim right)

My husband

his SSA date solely for PTSD was Nov 1,1991.

He applied for TDIU after his major 1151 CVA in Aug 1992.

His TDIU app was received by VA within one year of the SSA PTSD award date:

"the effective date will be the earliest date the evidence shows individual unemployability if a claim is received within 1 year from such date. Otherwise, the effective date will be the date of claim, provided that the evidence shows entitlement as of that date and the date is not prior to August 1, 1975. See 38 CFR §3.400(o). "

Both his 1151 claim and his TDIU claim were pending at his death and I continued those claims.Three years after he after died the VA awarded an accrued 100% P & T rating for PTSD as of the Nov 1,1991 date, posthumously because they cannot award TDIU to a deceased veteran.

(at least I don't think they can..I could be wrong and .I hope others chime in here on that. He did met the 100% PTSD criteria in the VA Schedule of Ratings.)

I would think if Voc Rehab, during the first year prior to a veteran filing for TDIU, declared the veteran unable to continue in or even begin to participate in Voc Rehab,solely due to their SC, that would also be a reason for VA to determine the EED as possibly due to the Voc Rehab documentation date, regardless of whether they were on SSA for any SC or not

Any thoughts on that?

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Posted · Report post

If the SSDI award preceded the date of the claim,it is possible there would be an additional year retro to the filing date.

I just hope VA is award of the SSDI award and has obtained those records.

"The Veteran was later required to remove his protective mask to assess the possibility of chemical agents."

Say what?

Sounds like a GPM (guinea pig maneuver) Geez

Maybe I misunderstood that.

You didn't misunderstand....

I filed for SSDI the same time I filed the VA Claim, SSI back-dated the SSDI 2 years but only paid 1 year retro from date of filing (they gave me a year SSDI backpay even though I was approved for SSDI in 3 months)

This is my part of my initial claim and is nearing the 2-year mark, just got the progress notes from the C&P which was over a year ago (7/25/12) - still no award from VA though - been a long wait.

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Are you hooked into ebenefits?

Sometimes the info there is hard to interpret I think....but often it has at least some sort of status...per the vets here who use it.

I wish I could use ebenefits. VA told me widow claimants cant use it because "DOD doesn't know who we are. "

Sure they do.

Boy the VA is so often full of S--T ,ooops I mean spin.

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I am using e-benefits, on there it was in Waco, TX but was moved to Lincoln, NE. On the WACO part it has "Gathering of Evidence" and on Lincoln, it has "Preparation for Decision", I was scheduled for an eye exam last Friday, so still doing C&P's. Original Claim date is 10/14/2011. The WACO one says anticipated completion date of 10/24/2014 to 06/09/2015 (It used to be in 2013), and the Lincoln one says "At this time, your Regional Office is unable to provide an estimated completion date for this type of claim" and "Regulatory or Procedural Review" for Claim Type.

I have 32 contentions, so it is a complicated claim and probably gets pushed to the bottom of the stack on a regular basis.

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32 contentions????????

Holy Cow.......I hope your main contention was the PTSD. They could award that and then defer the other stuff........

Are these all documented disabilities and/or secondaries or are many just symptoms?????

I have seen 20 or more claimed conditions at the BVA but 32.......no wonder they gave you a potential EP (end date) in 2015.

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According to my claim, my contentions are:

Contentions: posttraumatic stress disorder (New), left shoulder injury (New), hearing loss right ear (New), tinnitis (New), hypertension (New), traumatic brain injury (New), lower back injury (New), chronic fatigue (New), skin disorders (New), gastrointestinal signs or symptoms (New), cardiovascular signs or symptoms (New), depression (New), anxiety (New), liver condition (New), diabetes (New), chronic ear infections (New), hearing loss, left ear (New), hypothyroidism (New), sleep apnea (New), sleep disturbances (also claimed as nightmares with frequent waking and insomnia) due to GW undiagnosed illness (New), eczema (also claimed as skin disorders of the feet, leg, right hand, upper back, abdomen, and groin area) due to GW undi (New), shortness of breath (New), heartburn/reflux/GERD, (also claimed as hiatal hernia, and vomiting) due to GW undiagnosed illness (New), neuropsychological condition due to GW undiagnosed illness (to include depression with anxiety, cognitive issues/difficu (New), neurological condition with symptoms of tingling in hands, feet, arms, and legs with skin insensitivity due to GW undiag (New), muscle and joint pain(10/28/11 & 10/31/11) (also claimed as chronic wide spread pain to include neck, back, arms, legs, (New), fasciculation, legs, arms, and abdomen (also claimed as restless legs/arms) (New), migraine headaches (New), blurred and reduced vision (New), abnormal sweating (New), sexual dysfunction / erectile dysfunction (New)

31 or 32? something like that and a couple others I'm waiting to file on. Yes, all gtg for service connection and/or aggravation (though a couple might be a fight and/or secondaries and a couple will be rolled together)

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Mekon1971-

I know you are on SSDI for PTSD and your other service related conditions. That being acknowledged, this PTSD exam appears from my viewpoint, a service grant at 50%. The examiner did not mark the issues regarding work and social inabilities at the higher level of impairment what issues are marked are in the 30% to 50% ranges..

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Also, it may be a while before you have decision on your claim. The RO or at least the RO where I work, current protocohl states, the RVSR is not allowed to defer any contentions (claimed conditions) in the rating. So the RO has to rate all issues on your claim one way or another, if your claim has a date of claim bewteen 7/1/11 and 12/31/2012. Claims opened after 12/31/12 might be able to have deferred issues, but they are really frowning on defers right now, it just prolongs the claim and makes their STATS look bad. -IMO

You are right, 32 issues is up there in number. However, it used to be that who ever worked the claim would be penalized greatly/ unfairly, if there was one error out of thirty 32 issues. So one wrong would be 100% wrong. But they have changed that and now if there is an error in the Rating decision, it would be pro-rated at 1/32 wrong and combined with the rest of the RVSRs stats. So it is not so detrimental to work a claim with lots and lots of contentions. However, it is still alot of work and a 32 issue claim could take from 1 to 3 days to rate, depending on the complexity of the issues.

While looking at the DBQ results you posted here on Hadit. Some of them had the opinions included and some did not. Usually, if an opinion is requested it means the VA is either needing a current diagnosis of a condition, or the VA needs the doctor to provide a nexus linking the condition (contention) to military service. I noticed some postings of you DBQs were the plain DBQ no questions for the examiner. Most of the time when no opinion is sought and the DBQ is requested, there is evidence in the file and records show you have had treatment since military service. There is evidence of is a current diagnosis therefore there is evidence of chronicity and no opinion is needed. But, on some of your exams you posted the exam states you were not diagnosed until many years after your discharge. I am questioning the VSR/RVSR rationale for ordering an exam in the first place on sme of these DBQs

.

Did you serve during the RVN era? Just trying to work out some of my own questions about your recent slew of exams posed here at Hadit. - Harleyman

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Harley,

No, not a RVN era vet. Most of those exams were from a 2-day visit to the C&P clinic. And like you pointed out, most are clearly documented in SMR's but a few are related to G/W or are probably secondary to documented contentions. If there was an opinion, I put it on here, if there was not, I didn't. I only included checked portions of the DBQ's, if an area had nothing marked in it, I skipped over it to save on my typing.

P.S. Thank you for the time you are/have spent on my DBQ's - while I wait, it's nice to know what I need to try to get Nexus letters, buddy letters, etc. for.

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Did you have diabetis during your service? As the exam stated not diagnosed until 2009.

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