PTSD denied?

Discussion in 'PTSD' started by sgttank, May 25, 2007.

  1. sgttank

    sgttank New Member

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    Hi

    I applied for PTSD compensation with VA after coming back from Iraq and just got a letter from them today saying that they denied my claim and explained that i have anxiety disorder and not PTSD and therefore I do not qualify for compensation. However after applying for compensation and seeking help at the VA clinic I was told that they were backed up for several months ahead and I would have to wait or I could participate in a PTSD study that VA was conducting and for participation I would be provided help as needed without any wait time. So ofcourse I agreed to do the study because I wanted to get some help. The study was held at the VA hospital where I went through a bunch of tests and they determined that I have PTSD and suggested that I attend classes that they offer which teach people to deal with this type of thing. So I did. So VA doctors diagnosed me with PTSD, but my PTSD claim was denied? That makes no sense to me. I mean, I spend a year in a combat zone, I provided them a letter with stressors, which they asked for, and on top of that a VA doctor diagnosed me with PTSD. What should I do?

    If anyone knows anything about these things I would apreciate any kind of input.
  2. rainvet

    rainvet New Member

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    I can't said for sure because not one can until and unless they go through the sames problems you have, but since I have, I'll just say that you should push on all the way to DC and never let up if you feel strongly about your claim and know if for honor and not just for income per-say.

    Keep it going and see what happen and you can always drop your claim and you can also have a new claim on others problems at the same time.

    Please don't do this just fro the money but for the lost of something from your Military Duty. I was granted with Anxiety Reaction {Neuro} in 1970 and was giving 10% Service-Connected and never know what that was until I lose my last job and someone told me to go to the VA and they would help me with my Medicine. I didn't go there for anything except that and never know that my disorder could nor ever would be anything but what it has been for over 30 years.

    The VA doctors some how help me get to the 100% for Ptsd and that all I know, but do thank them all for helping me understand what my problems are and how to manages them the best anyone can. RainVet
  3. TinCanMan

    TinCanMan Active Member

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    The decision maker at the RO denied your claim because there was no medical opinion of a PTSD diagnosis (it's required). At the time of filing, the only diagnosis was the C&P examiner's diagnosis of anxiety disorder and not PTSD. Later you seek treatment and the psychiatrist diagnoses PTSD. Understand, the RO doesn't moniter your health care for any possible changes.

    File a notice of disagreement and ask for a DRO review if less than 1 year from date of decision. Otherwise, file a claim and ask for reconsideration based on new and material evidence (the new doctor's opinion).

    FWIW, your claim may still be denied if your new doctor made his decision based on your testimony of the facts. The C&P examiner has access to your C-file which contains your Service Medical Records and personnel record. Your doctor has no access to these unless you gave him a copy.
  4. mac

    mac New Member

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    I was rated 50% PTSD and they said it would have been higher if they had evidence that I had suicidal and homicidal ideation, yet in the paragraphs above this one (describing how they rated me), they clearly stated the incidents/psychiatric hospital stays where I was suicidal/homicidal... fck them!!!
  5. janderson06

    janderson06 New Member

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    Sgttank
    I wonder if you have talked to a Service Officer. You can find one at the D.A.V. , V.F.W., or American Legion. You may even have a state or county officer. Anyway, it's good to have someone who can explain the process to you. I was in Iraq 03 to 04 and am still dealing with the VA. The therapy has helped and the medication has helped, but it's been a rough row to hoe. What TInCan Man said is true, if the Psych at the C&P did not diagnose you with PTSD but the VA Doctors have now you should be able to reapply. It's hard when you don't know the ropes. That's why I hope you find a service officer. I went to the VFW and my rep has helped me understand and navigate my way successfully.Hang in there and good luck.
  6. USMCTanker

    USMCTanker New Member

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    If you have these you have PTSD.

    Symptom logy of PTSD:
    Recurrent intrusive distressing recollections
    Recurrent distressing dreams of events
    Hallucinations and dissociate flashbacks
    Inability to recall aspects of the trauma
    Diminished interest in significant activities
    Inability to show affection to others
    Feeling of detachment or estrangement
    Sense of bleakness with regard to the future
    Difficulty getting to and staying asleep
    Intense psychological distress
    Irritability or outbursts of anger
    Inability to concentrate fully
    Exaggerated startle response
    A multitude of physical problems
    Feelings related to guilt
    Substance abuse and addiction
    Psychic numbing
    Major Depression
  7. TinCanMan

    TinCanMan Active Member

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    USMCTanker:

    It doesn't matter what you think you have. If you don't have a diagnosis of PTSD from a physician licensed to make a diagnosis, you don't have PTSD and your claim will fail. Get a diagnosis. This is one of the prime reasons vets get pissed off at the VA for not granting their claims. The law requires a diagnosis and without it, the VA can't approve a claim.
  8. USMCTanker

    USMCTanker New Member

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    I agree with you on the need for a diagnosis of PTSD from a psychiatrist. It is best to have a PTSD diagnosis from a VA psychiatrist. A diagnosis from a medical doctor of PTSD will not qualify for VA purposes.

    I have been 100% total & permanent since 1990. I am not 70% rated 100% due to un-employability.

    TinCanMan,

    The purpose of my listings the PTSD symptoms was to educate those that have the disorder but don't realize that the symptoms they are having are related to PTSD.

    I knew something was wrong and it was nearly 5 years before I went to a VA Walk-In Center and spoke with a counselor. It only took 10 minutes before I realize that the symptoms I was experiencing were indeed PTSD.

    I was than able to request a new C & P based on new evidence. I was then able to relate to the examiner that my symptoms were, ending in a rating for PTSD.

    It would take another 2 years to get a 100% rating from the VA and that was only after I was awarded Social Security Disability. I used the SSD determination letter as new evidence for 100% PTSD rating.


    38 C.F.R. § 4.130, DC 9411
    General Rating Formula for Mental Disorders:

    Total occupational and social impairment, due to such symptoms as: gross impairment in thought process or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation occupation, or own name …………………..100%

    Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships ...................................... 70%

    Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining Effective work and social relationships ………………..50%

    Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events) ............................ 30%

    Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication .................. 10%

    A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication .............................. 0%
  9. TinCanMan

    TinCanMan Active Member

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    Not necessarily. If the private physician licensed to make the diagnosis states he has examined the veterans Service and Medical records and states that it is his opinion the veterans PTSD is, at least as likely as not, the result of his military service because... and provides a plausible rationale. his opinion will carry the same weight as that of a VA C&P examiner. It will then be up to the decision maker to choose the opinion which he believes to be most factual. If he cannot decide, he can ask for another C&P, more information or whatever he needs to find a decisive opinion.

    I never said that. I said: "physician licensed to make a diagnosis". A psychiatrist is a physician licensed it make diagnoses of mental conditions.

    Great, no problem. Start your own thread with a clear subject line. No one in this thread appeared to be confused regarding PTSD symptoms.
  10. USMCTanker

    USMCTanker New Member

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    Seem to be a little touchy. Sorry I have posted my own personal experiences.
  11. TinCanMan

    TinCanMan Active Member

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    Not touchy at all. You implied my advice was wrong, when in fact, it wasn't. Under those circumstances, you can make book I'll say something. Not that I'm never wrong, That happens often enough and more often than I'd like. This just wasn't one of those times. When I'm wrong, I'll usually acknowledge it or go sulk in the corner a while.

    That's not a problem either. Everyone's personal experiences are welcome. Veterans forums would die out without veterans telling their story. You said it was best to have a VA psychiatrist provide your PTSD diagnosis. That isn't so and I explained why but I made a slight mistake there. I assumed by psychiatrist you meant a C&P examiner, but that's not what you said at all. You said psychiatrist which means a medical practitioner providing you treatment. In that case, a diagnosis is a diagnosis and anyone licensed to provide a diagnosis carries the same weight as any other person licensed to do the same. Now, if you were talking about a nexus, The C&P examiner may carry a bit more weight because he is required to read your c-file which contains your Service Medical Records as well as your Service Record Book. This gives him a bit of an advantage when he opines about service connection. A private psychiatrist may not have access to those records and is limited in his ability to make the connection between your service and your condition (Nexus) unless you gave them to him and he says he read them.
  12. adjdmint

    adjdmint New Member

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    i AGREE WITH ALL OF THE OTHER POSTS, HOWVER, IN ORDER TO LEAVE NO STONE UNTURNED, YOU SHOULD GET AN OPINION "IS IT AT LEAST AS LIKELY AS NOT THAT THE ANXIETY DISORDER BEGAN IN MILITARY SERVICE." mANY VETERANs AGONIZE OVER THE DIAGNOSIS OF A MENTAL DISORDER. THE DIAGNOSIS DOESN'T MATTER TO VA RATING BOARD AS ANXIETY DISORDERS, DEPRESSION, BIPOLAR DISORDERS, PTSD, AND IN FACT, ALL MENTAL DISORDERS, EXCEPT EATING DISORDERS, ARE RATED WITH THE SAME CRITERIA. SO IT DOESN'T MATTER WHAT IT IS CALLED, WHAT MATTERS IS "CAN IT BE SERVICE CONNECTED?" SO, WHEN YOU FILE AN APPEAL, YOU WOULD STATE THAT YOU WOULD LIKE FOR AN EXAMINER TO REVIEW YOUR CLAIMS FILE AND GIVE AN OPINION WITH RATIONALE IF YOUR CURRENTLY DIAGNOSED ANXIETY DISORDER AT LEAST AS LIKELY AS NOT BEGAN IN SERVICE. YOU CAN ALSO PURSUE THE PTSD DIAGNOSIS AT THE SAME TIME, TELLING THE VA YOU HAVE NOW BEEN DIAGNOSED WITH PTSD. IT IS HARDER TO GET SERVICE CONNECTION FOR PTSD BECAUSE YOU HAVE TO HAVE A DIAGNOSIS OF PTSD, THEN YOU HAVE TO HAVE A VERIFIABLE STRESSOR, OR A RECOGNIZED COMBAT MEDAL, SUCH AS PURPLE HEART, COMBAT INFANTRY BADGE, ETC.

    THERE ARE HUNDREDS OF VETERANS IN TREATMENT FOR PTSD THAT NEVER EVEN SET FOOT IN VIETNAM, BUT TOLD THE VAMC EXAMINERS THEY WERE IN COMBAT IN VIETNAM, AND THE VA HOSPITAS TREAT THEM FOR PTSD, WITHOUT TRYING TO VERIFY THEIR STRESSOR. HOWEVER, THE REGIONAL OFFICE CAN'T GRANT SERVICE CONNECTION FOR PTSD UNLESS THERE ARE VERIFIABLE STRESSORS. SOMETIMES, TRYING TO VERIFY STRESSORS TAKES YEARS.

    SO, FOR EXAMPLE, YOU GO TO A CAR DEALER AND WANT TO BUY A NEW CORVETTE. THE CAR DEALER SHOWS YOU A BRAND NEW RED CORVETTE CONVERTIBLE, AND TELLS YOU THE PRICE IS $60,000, THEN YOU GO TO ANOTHER DEALER AND HE SHOWS YOU THE EXACT SAME CORVETTE, WITH THE EXACT SAME PRICE, BUT HE KEEPS CALLING IT A SUBARU. YOU KEEP CORRECTING HIM THAT IT IS A CORVETTE, HE KEEPS CALLING IT A SUBARU. DO YOU CARE WHAT HE CALLS IT? NO, A CORVETTE IS A CORVETTE, NO MATTER WHAT SOMEBODY CALLS IT.

    SAME WAY WITH A VA MENTAL DISORDER. THEY ARE ALL TREATED THE SAME BY THE VA RATING BOARD. YOU CAN GO UP TO 100 PERCENT FOR AN ANXIETY DISORDER, WITH THE EXACT SAME SYMPTOMS THAT YOU CAN GO UP TO 100 PERCENT WITH PTSD. THE RATING CRITERIA IS EXACTLY THE SAME. SO, DON'T SWEAT THE DIAGNOSIS, THE TRICK IS TO GET WHATEVER MENTAL DISORDER YOU'RE DIAGNOSED WITH LINKED TO SERVICE. THEN, SERVICE CONNECTION CAN BE GRANTED.

    THERE ARE THOUSANDS OF VETERAN SERVICE CONNECTED FOR DEPRSSIVE DISORDER. THEY WILL SPEND YEARS TRYING TO GET SERVICE CONNECTION FOR PTSD. THEY HAVE TO JUMP THRU HOOPS TO GET A PTSD DIAGNOSIS AND GET THEIR STRESSORS VERIFIED. THEN, AFTER TYING UP THE VA SYSTEM FOR YEARS, AND BEING MAD AT THE VA FOR YEARS, THEY MAY OR MAY NOT ACTUALLY GET SERVICE CONNECTED FOR PTSD. SO, IF SERVICE CONNECTION IS GRANTED FOR PTSD, WHAT DOES THE VA DO? THEY CALL THE NEW DISABILITY 'DEPRESSIVE DISORDER WITH PTSD" AND GIVE IT THE SAME EVALUATION THAT THE VETERAN ALREADY HAD FOR DEPRESSIVE DISORDER BY ITSELF. NO EXTRA MONEY IS GRANTED. THAT'S BECAUSE ALL MENTAL DISORDERS HAVE TO BE RATED AS ONE ENTITY. IF THE VETERAN LATER GOT DIAGNOSED AND SERVICE CONNECTION FOR BIPOLAR DISORDER, IT WOULD BE CALLED "'DEPRESSIVE DISORDER WITH PTSD AND BIPOLAR DISORDER'', AND HIS PERCENT OF DISABILITY WOULDN'T CHANGE.

    THESE ARE THE REASONS THAT SO MANY VETERANS ARE IN TREATMENT AT VA HOSPITALS AND VETERANS CENTERS FOR PTSD, AND THE VA REGIONAL OFFICE WON'T GRANT SERVICE CONNECTION FOR PTSD. THE VAMC'S AND THE VETERANS CENTERS DON'T HAVE TO VERIFY STRESSFUL EVENTS TO GIVE TREATMENT. THEY RELY SOLEY ON THE ORAL TESTIMONEY OF THE VETERAN CONCERNING COMBAT, ASSAULT, OR ANY OTHER FACTOR CAUSING PTSD. THESE STRESSFUL EVENTS MAY OR MAY NOT HAVE ACTUALLY HAPPENED. ON THE OTHER HAND, THE REGIONAL OFFICES THAT GRANT THE CLAIMS HAVE TO HAVE VERIFICATION OF STRESSORS BEFORE THEY CAN GRANT SERVICE CONNECTION FOR PTSD.
  13. adjdmint

    adjdmint New Member

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    Lots of times, the record shows suicidal ideation or homicidal ideation years ago. The VA rates on the symptoms that were shown from the date they received your claim, forward. They don't care what your symptoms were like when you left Vietnam, or what symptoms you had years ago, they can only rate on the current extent of your disability. Could this be what happened in your case?
  14. USMCTanker

    USMCTanker New Member

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    TinCanMan,

    You are doing a good job and I thank you for that.

    I find you to be abysmal in manners and somewhat dispirited.

    I know, I know that's not your problem either.

    A little diplomacy on your part could go a long way in not chasing other veterans away. It's your choice and that is your problem.
  15. TinCanMan

    TinCanMan Active Member

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    My only interest is providing veterans with accurate information regarding the claim process and some insight on how the VA works. I didn't come looking for friends and I'm not a veterans advocate, activist or cheerleader. I am what I am. Take from it what you want and ignore the rest. Some folks like plain talk, others want sugar coating. I don't do sugar coating.
  16. USMCTanker

    USMCTanker New Member

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    I like simple talking as well. However, if one is to get along with the human race we must develop better communication proficiency. One is never too set in their ways not to want to better themselves. You may be the exception,
  17. pathfinder74

    pathfinder74 New Member

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    Not that I advocate fabrication of symptoms, BUT... to the best of my knowledge your best bet for getting rated with PTSD is to tell them you have nightmares AND trouble sleeping, you have sexual "difficulties", you experience anxiety regularly, and you are fatigued and depressed you are pretty much set.

    If you don't necessarily recall having any of those "symptoms" then you should at least be aware of them should you experience them. As far as I can remember they don't inquire as to the frequency of these symptoms, only if they happen. But if they do, not being able to remember can always be considered a symptom as well. LOL

    Read through the files on this page and you might have a better idea of the "qualifiers".
  18. TinCanMan

    TinCanMan Active Member

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    Pathfinder:

    We don't coach folks on how to commit fraud. You tell the C&P examiner exactly what symptoms you have. Nothing more, nothing less.
  19. pathfinder74

    pathfinder74 New Member

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    Not coaching.... simply telling them what they already know but don't know how to verbalize at the appropriate time. ;)
  20. TinCanMan

    TinCanMan Active Member

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    I call that coaching even though you later go on to sorta imply they shouldn't do that unless it's so. That followed by a LOL.

    We don't do that here and we don't help folks "remember" all those things that qualify. That nonsense may fly at the vet center but it isn't acceptable in someone elses forums.

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