Combat PTSD Compensation

A Combined Ratings Formula You Can Use

2012-01-30T05:29:00.000-05:00

Combined Ratings Formula

When a veteran has more than one disability the VA combines them, based on the principle that a veteran can never receive more than 100% disability. I’ve met veterans with up to five distinct 100% disabilities, but there is no way to go past 100% for compensation without receiving an additional letter award for loss of use or missing limbs.

The VA and service organizations use a rather complicated numerical formula involving fractions to combine percentages, but there is a simple way to do it that will be accurate 99% of the time, if not all the time. I call it the Disabled-Wellness Formula.

I will use a veteran with three disabilities received in this order: 30% for back injury, 10% for hearing loss, and then 30% for PTSD.

Added up they total 70%, but they will actually combine out to 60%. The veteran will lose 10% in the process.

This is how it works:

The original 30% back injury service connection makes the veteran 30% disabled but leaves the veteran 70% wellness (functional).

When the veteran receives an additional 10% for hearing loss, you multiply 70 x 10 ( you multiply the new percentage by the amount of wellness and drop the zeroes on the end.)

This leaves a total of 7. Any result below 5 means no increase. A result of 5 or above means going to the next higher percentage.

In this case, a 7 means going up to a 10% disability. The veteran loses nothing and will now have a 30% back injury rating plus a 10% hearing loss rating for a total of 40%.

The veteran has a 40% disabled and 60% wellness. But the veteran now receives a PTSD service connection rated at 30%. When you add them all together, it equals 70%, but due to the combined formula, it doesn’t turn out that way.

You multiply the new 30% by the wellness 60% and drop the zeroes for a total of 18.

Since the 8 is above a 5, you go up to the next higher percentage. In this case, the 18 goes up to a 20. The veteran receives and additional 20% disability rating, even though he was granted 30%.

The veteran now combines out at 60% even though he is 70% disabled and only 30% well.

* * * *

We can take it even further. Say the veteran gets another 50% for a brain tumor.

Multiply the 60% by the 30% wellness and drop the zeroes. In this case, it’s a total of 18.

Since it’s 5 or above, the 18 goes up to 20%.

The veteran would get a combined rating of 80%, even though he is now 120% disabled.

This combined 80% rating would leave the veteran a 20% wellness, meaning he would have to obtain another 50% disability to get another 10% on the combined percentage.

To obtain enough percentage to actually reach 100% combined, the veteran would need two more 50% disabilities, leaving him actually 220% disabled to receive 100%.

This probably wouldn’t be necessary by then because the veteran would probably be rated unemployable and get the 100% for unemployability.

I imagine there are one or two instances where this formula could be wrong, but for most circumstances, it will work when a veterans want to figure their own combined rating.

Answers From The VA Question Bag

2012-01-09T14:50:00.001-05:00

Contact email

How can I request a waiver to not pay back the debt?

To request a wavier you need to explain, in writing, the reasons you feel that you should not be held liable for your debt. Please explain the circumstances leading up to the overpayment, and the steps you took to prevent the overpayment from occurring. You should also complete and return the Financial Status Report (VAF 20-5655), which was enclosed with your notification letter.

I filed a claim for unemployability due to PTSD. I told the DAV rep I was 100 percent disabled from Social Security for a physical disability, but he didn't want to use that information for now. I told a VSO the same thing and he said to use the information. What should I do?

The VA is supposed to consider information from Social Security is you want them to, but...if you are 100% from Social Security for a physical condition, don't use that information in a PTSD claim because the VA could argue that you're unemployable because of the physical condition and not the PTSD, even though PTSD is the major problem. This could increase delay time for adjudicating the increase. The DAV rep is suggesting the smart move.

Is there any advantage to filing a claim for Type 2 Diabetes when I’m already 100% Unemployable?

If you have been unemployable for at least ten years, there is no real advantage. You get treated for everything anyway after 50%. But if you have only been rated UE for a few years, you must die of your service connection to make your spouse eligible for DIC survivor benefits. So if you were unemployable for PTSD and you died of complications from Type 2 Diabetes, but you were not service-connected for it, your spouse may have a hard time collecting DIC even though you were 100%.

So below ten years unemployable, I would file. After ten years, you’re covered for any illness that can kill you so it’s not that important if you are total and permanent. It’s all about our wives or minor children if we have them. So I guess I would have to say file the claim, especially for Type 2 or any other Agent Orange related illness because it’s considered presumptive, and if you have it you get an automatic service connection.

If I am rated 100% for unemployability, can I do any kind of work at all?

You can work as long as it’s not long term full time employment for a year or more. You can also help out in a family business or have scattered employment as long as it’s not long term full time employment. If you have your own business and show a huge income to the IRS, that could be a problem with the unemployability rating because you are able to support yourself.

The VA always sends me a paper every year wanting to know if I had taxable income or wages that were subject to Social Security. I imagine they will begin sending all kinds of papers to anyone on unemployability in the future, trying to find out if your ability to make money is restored.

Just remember, working a few days a month or helping a family business on a scattered basis does not mean your earning capacity is restored. Being restored means a regular full time job.

Can the VA take away my money award?

Generally, for physical disabilities, the VA can reduce your compensation, even for combat wounds, if the condition improves to the point where it has no effect on your life.

For PTSD, once you are service-connected, you are pretty much service-connected for life. There is no cure for PTSD, and once you have a percentage for five years, the VA would have to review the entire claim history before cutting your percentage. They can call you in for Comp Exams, and they can give you a high GAF score on a given day. Just because you may feel good on a given day, doesn’t mean you are cured. And they cannot reduce you for a temporary improvement in your condition.

How long should it take a claim for unemployability to be granted?

There is no way of telling because each case and RO is different. For PTSD, when it is the only disability, it shouldn’t take more than a few months is you are rated 70%. If you meet the combined criteria for unemployability for physical wounds or other disabilities, then it may take longer because the VA deals with each disability as it rates to working. The only good thing in waiting is that it will probably go back to the last day you worked or back to the day you filed. I’ve known a few vets who received over $100,000 in back pay by the time it was over. The main thing is to not give up when you have a good claim.

My View On Combat PTSD

2011-12-31T15:43:00.000-05:00

Combat PTSD

Have you seen a change in the stigma associated with PTSD and "mental health problems"?

There isn’t much of a change except no one refers to troubled veterans like they did in the Vietnam Era as the "crazy Vietnam veteran". You never hear the "Crazy Iraq veteran". I also feel since so many people are claiming PTSD, many for being separated from their family or being forced to serve outside the US on many tours, the term PTSD is being softened too much and those who may really need help will be neglected.

Some soldiers suffering from PTSD commit suicide. What do you think stops them from getting the help that they need (in general)?

I don't believe having PTSD makes you suicidal. If you are a combat veteran with PTSD, you are normally a survivor and will survive at all costs. That's what the military teaches. Your job is to kill the enemy and survive to do your job.

I think many military suicides today are from family problems back home because many more people are married. I saw guys in Vietnam get Dear John letters and lose it. I had to wait nine months to get one two minute call to the states when I was in Vietnam.

Today with communication being so good, troops can be close to home each night or stay in touch. So they have to deal with their own problems and the problems back home, too. It's a bad idea to give troops cell phones and computers. So I figure most people who kill themselves were mentally ill going in because of lower standards of admission or they had family problems. I don't think many kill themselves over combat issues. This is just my view of things. I’m sure some psychologists would argue with me, but most of them will have not served in combat.

Explain what you're doing specifically to help those with PTSD and why it's important to you.

I have dealt most with Vietnam veterans, but some veterans of all wars. What I do is listen. I've been there and I wrote the original instructions for PTSD claims the VA uses while I was a work-study under Voc Rehab. Most veterans want someone to listen to their stories and to guide them through the PTSD claim process. The service organizations don't have the people to do that. The service officers often don't know what to do or have so many cases they can't take the time to listen or help beyond filing a claim. That's what I do.

I've had calls at all hours of the day and night, and several times vets have come to my house for help. Most times I've never met the vets I help. I write a bi-monthly newsletter, The S-2 Report, and I've published it for 18 years. Many of the vets have subscribed since the first issue. Helping other combat vets makes me feel I'm still fighting the war in a positive way and helping others I couldn't help during the war. I have issues with survival guilt.

Do you think that some veterans are just falling back on PTSD to avoid trouble? What do you think that this does to compromise those who truly have a problem?

I think PTSD has often been used as an excuse for crimes or bad behavior, and most times criminal behavior has nothing to do with PTSD. PTSD will not make you torture or kill your family or beat your wife and kids or rob banks and rape children or others. Anyone who did those things and claimed PTSD had issues before their military service, like alcohol and drugs or previous mental illness. PTSD is a convenient excuse for crime in many cases when every other defense fails. PTSD is a reaction to combat situations, which usually involves survival and fear of loss and the inability to not be on guard 24/7. If a PTSD vet is attacked by strangers, the vet will usually react with deadly force if possible, but having PTSD is by no means an easy excuse for criminal behavior.

What do you think would help to lower the PTSD rate in the military?

My solution to prevent PTSD, or an idea that would go a long way in preventing PTSD, is to require the MMPI for every recruit to uncover personality disorder, and to make it a requirement that all new recruits be single without dependents.

Also, all daily communication with home should be severed in a combat zone and should be rationed like in previous wars. I believe that would not only lower the suicide rate but it cut the rate of severe PTSD.

A soldier cannot face war daily and deal with problems at home at the same time. The politicians would dismiss this route as impractical because they would have to begin a draft, and bringing back the draft might hurt them during election years.

S-2 email

Law and Order Is Breaking Down

2011-12-26T07:25:00.000-05:00

The Criminals Are Winning

Here is some inside information out of Cincinnati, which I believe can be applied to many cities in the country. The criminal cases number 35-40 thousand a year, over 100 a day. Most criminals have an open-end get out of jail free card.

There are currently no women in Cincinnati jails, unless they have done something extremely violent. Right now there are no women being held in the system.

For men, almost any crime short of murder rates probation instead of jail time. Breaking and entering, robbery, drug offenses, etc., all probation offenses and the criminals let out on the street to do it again. Probation departments can't possibly handle or track all their clients.

There is no room in the jails, and the funding keeps getting cut. Crime in Cincinnati is rampant, with multiple shootings almost everyday. We are on the verge of a society where citizens will have to fend for themselves because the police and courts will no longer be able to help.

If you have no means other than good intentions to protect yourself or your family, it is time to arm yourself for defense or you chance of become a victim increases daily.

PTSD Veterans

For a combat veteran suffering with PTSD, this can only lead to a heightened security approach to home and family defense. PTSD veterans don't need additional paranoia to complicate their daily lives. But it is here whether we want it or not.

In some ways this is a good thing. PTSD becomes part of your permanent personality, and is horrible to live with 24/7. But having a combat veteran in the home, especially one with PTSD, creates benefits for family protection. Like a good watchdog, we will always have our perimeter secure. We will have enough weapons within reach. We won't try to reason with the enemy, and we won't hesitate to protect our family unit and home base camp.

I once asked a hardcore anti-gun liberal what they would do if someone broke into their house to rob and possibly kill their family.

"If we are supposed to die that way then we will," the person said.

I was shocked at the answer. It doesn't register in my brain to just give up and not protect my family. In fact, such behavior is psychotic and goes against the will to survive. And that's one thing most combat vets are going to do: survive.

So don't let your guard down. As combat veterans we are still this country's most valuable asset in preserving our freedom.

PTSD Comp Exams Again?

2011-12-16T04:43:00.000-05:00

I’ve heard from several veterans in the past few weeks about being called in for PTSD Comp Exams after they have been 100% unemployable for years. It’s usually those who are not P&T (Permanent & Total) who get called in, because the VA can call them in at any time just like they do for vets with physical wounds and certain cancers: just to see if you have improved enough to cut your percentage.

Each new administration in DC gives orders to cut veteran benefits. In public, they say how they are going to continue to help veterans, but it’s only because they have to help us. Behind our backs, they always try to screw us over. Most politicians aren’t veterans, and they don’t want to waste money on people they have used up.

But, I told the veterans not to worry for several reasons.

1. PTSD never goes away or gets better to the extent that it can change the way you function or the way you react in the workplace. If the VA agrees you are unemployable, and you are a Nam vet past prime working years, you will remain unemployable.

Voc Rehab isn’t likely to accept an unemployable Nam vet even if the VA says the vet is now employable. And if Voc Rehab turns you down, there is no other alternative except to make you unemployable again.

Even if Voc Rehab did say they would accept you for retraining, there is no guarantee you will employable after training. So you would stay unemployable while in training, and if you did make it through the training, you would be unemployable until you found a job, if ever.

Since the VA is trying to save money, Voc Rehab is not a very thrifty alternative for an unemployable Nam vet.

(I went through Voc Rehab years ago before I was even rated unemployable. I went to school full time and worked for the VA work study program after school hours for minimum wage. My goal was to work in publishing or become a publisher. I got my BA in English, but since the SBA considered publishing to be too risky, I couldn’t get a business loan and I couldn’t make enough freelance to support myself. After a stint as a DVOP for Ohio, I was rated unemployable when that job ended. Voc Rehab does not guarantee employment success.)

2. A sudden higher GAF rating does not mean a reduction is in order. The GAF (Global Activities Function is one way to say it) is often used to show how a veteran is feeling on a given day. Usually, 50 or above means pretty close to normal. Most vets with PTSD will be in the 30s and 40s. Below that is almost considered comatose in the ability to communicate or hold a job.

A GAF rating is an opinion of one health professional on one given day. Just because a PTSD veteran feels good one day, doesn’t mean he will feel good the next day.

The GAF cannot be used to take a percentage away from a PTSD rated veteran. And if they tried, you would win on appeal.

3. There is a ten year rule for PTSD and unemployability. If you have the same percentage for 20 years, it’s yours forever, so they say. Actually, after five years you are pretty secure with PTSD. After ten years at unemployable, the VA cannot lower your disability without reviewing the entire case history of the claim. And chances are, they would always lose in the appeal unless you have been working full time on a permanent basis.

So, if you have PTSD and have been rated unemployable, whether permanent or not, the chances of your percentage being cut is slim to none. They may call you in for a Comp exam if you are not permanent, but they are just going through the motions.

The PTSD percentage is based on your ability to support yourself in a manner equal to non-veterans in your age group. It is not based on how you feel on any given day. If you are unable to work long term and full time, your percentage cannot be cut without violating the CFR regulations.

(Look for Dennis Latham books and stories on Amazon and B&N. Email contact: ysgazelle@gmail.com)

How Has PTSD Changed You?

2011-12-06T07:00:00.001-05:00

Camp Books 122 rocket strike on bunker Tet 1968

(from the S-2 Report Newsletter by Dennis Latham)

How has PTSD changed you?

I have long term PTSD. I don’t drink and I’ve never done drugs. I have to maintain iron control and always be ready to defend my perimeter. I’m most at ease around other combat vets. Combat vets are my extended family.

I can’t go to bed until I’ve checked the perimeter and set the alarm. I refuse to be ambushed. My dog stays up all night on 100% alert. I would sleep a lot less if she wasn’t there to stand watch. When I wake up, I’m up fast and fully alert. I’ve trained myself to respond within a few seconds.

Strangers are like objects to me. If threatened, I would try to avoid the situation, but would feel no regrets about taking them out because in my military mind they are not human.

I couldn’t live in a crowded subdivision or in the city so I remain isolated. I don’t understand people who have never been in the military and don’t feel the need to have a weapon. I guess that’s a carefree way to live, but from my viewpoint, not very realistic. If something happens, they will be the first to suffer because they can’t protect themselves. I have a weapon within reach anywhere I go in my house: guns, swords, hatchets, knives.

Before I was married and had heavy curtains, I taped dark garbage bags over many of my downstairs living room windows. I couldn’t sit in that room at night on the lower floors just knowing someone could see inside and possibly ambush me. I know this may seem crazy, but this was the way I had to live at the time.

I’ve known others who are more extreme. I knew a Nam vet in Alaska who had a shooting range in his living room. I have a range in my yard. I like to go shooting with my Nam vet Marine friend Rocky. I feel comfortable around him.

We all deal with PTSD in our own way. It’s unfortunate that many combat veterans deal with PTSD by alcohol and drug addiction. When that’s added to anti-depressants, often mixed all together, the results can be deadly.

The worse thing I face with PTSD, despite thinking about Vietnam each day, is knowing that I’m a different person than I could have been had the war not intruded on my life. I look at the few old pictures of myself from before the war, and I don’t even remember that guy.

I could see the change years later in the few pictures I had from Vietnam, taken well into my tour. I looked different. My eyes looked almost hollow, like there was nothing behind them or I was hiding something from the camera. I had changed forever. Time marched on, but inside, I still struggle to find the person I was before the war.

PTSD and Sleep

2011-11-08T05:06:00.000-05:00

Less Sleep Helps PTSD?

In a new study published in the journal Biological Psychiatry, researchers from the National Institute of Mental Health in Tokyo were interested in the relationship between sleep deprivation and fear associated with post traumatic stress disorder (PTSD). PTSD is a serious disorder where, after some type of traumatic event (combat, natural disaster, abuse, etc) involving the threat of injury or death, the person can suffer from a debilitating anxiety disorder that involves:

a heightened sense of awareness
(insomnia)
reliving the event
(nightmares)
avoidance of things that remind them of the event
(movies, sounds, crowds)

guilt about their survival
(imagining the event to a different outcome)

In this experiment, researchers had two groups of healthy volunteers. Everyone watched a film with traumatic content and then one group was able to go to sleep, while the other was forced to stay awake for 24 hours (total sleep deprivation). Amazingly the group that had to stay awake had less measured fear of the film content than the group that got to sleep.

The researchers hypothesized that a case of sleep deprivation, like acute insomnia after a life threatening trauma, may help people not form the fearful memories of the traumatic event. Not long ago I blogged about sleep and memory. More specifically, we know that rapid eye movement sleep ( aka REM sleep) is when we see a good portion of the mental restoration that goes on in the brain. This is the time when we move information from our short term memory into our long term memory, and organize our thoughts in such a way that they can help us recall information later on. Could it be that with total sleep deprivation the brain is not allowed to form a long term memory of an event? While this may be possible, more research is certainly needed to better understand this complex situation.

Wasted VA Money

2011-11-05T05:49:00.000-04:00

Wasted Money VA

The Department of Veteran Affairs spends $175 million annually on upkeep of hundreds of empty buildings, including an unused "monkey house."

The VA, according to the Dayton Daily News, disputes the figure, claiming it only spent $34 million a year on such activities--roughly equivalent, using median figures, to the annual income of 560 U.S. families.

Shrimp On Treadmills

Scientists created a study to see if sick shrimp displayed the same endurance on a treadmill that a healthy shrimp did. This project boasts the impressive price tag of 3 million dollars.

World of Warcraft

This research explored how "online virtual worlds such as ‘World of Warcraft’ and ‘Second Life’ can help organizations collaborate and compete more effectively in the global marketplace." 2.9 Million (It also found way to legitimize playing video games at work.)

Study About Baby Names

This study aimed to ferret out how quickly parents respond to trendy baby names. The astounding conclusion: “Popular names are popular with parents.” 1 million dollars.

Current Legislation

2011-06-07T13:26:00.000-04:00

Legislation (from the S-2 Report/June 2011)

The House Committee on Veterans’ Affairs will hold a hearing on mental health programs available through the VA on June 14, 2011. Tuesday’s ruling by the 9th U.S. Circuit Court of Appeals that cites “unchecked incompetence” by the VA in handling post-traumatic stress cases will also be addressed at the hearing.

H.R. 1407, the Veterans’ Compensation Cost-of-Living Adjustment Act of 2011 (introduced by Rep. Runyan, Rep. LoBiondo, and Rep. Stutzman) – as amended.

(The big drawback in this, from what I can discover by reading the bill, is that the increase goes up by the same amount as the Social Security COLA increase. Since the SS increase is froze, it appears we may not get a COLA increase again. So unless something changes, this legislation has no basis in reality for veterans and remains an empty shell.)

H.R. 1484, the Veterans Appeals Improvement Act of 2011 (introduced by Rep. Filner) – as amended. H.R. 1484 would establish a commission to evaluate the process of judicial review for veterans’ and survivors’ benefits. The Veterans Judicial Review Commission would be charged with recommending ways to improve aspects of the appellate review process as it relates to veterans’ benefits, including its accuracy, timeliness, and transparency.

The commission also would be asked to determine the advisability of authorizing the Court of Appeals for Veterans Claims to hear cases brought on behalf of a group, such as class action suits.

(The Appeals Court has seemed to be a fair process in the past, but what really needs to be improved is the time involved in resolving cases. Often, it takes years to resolve cases when the VA turns down claims just because they can or an adjudicator wants to empty his claim file. Adjudicators who turn down good claims without plausible reasons should be charged with a federal crime if the veteran dies while waiting for a resolution. The claim should also be instantly granted by the Appeals review and not sent back to the Regional Office for more Comp Exams and months of waiting.)

PTSD: Filing A Claim Without A Diagnosis

2011-04-07T16:21:00.000-04:00

If I want to file a claim, do I have to have a diagnosis first before I can file?

Some service organizations will tell veterans they have to have a written diagnosis from a doctor before they can file a claim for any condition. This is not true. A veteran can file a claim at any time for any condition related to military service. You do not have to prove it before you file, and a service organization cannot refuse to let you open a claim.

Many service officers seem to be in it for the job and don’t care about helping veterans or they don’t want to make waves with the VA. The VA pays for their office space at the hospitals, and more and more I hear veterans complain that service officers often seem to side with the VA. If a service officer, from any service organization mandated by Congress to help veterans, tells you that you should stop whining and be happy with what you have...or if they tell you that if you file for an increase in PTSD that you risk losing your percentage...then tell them you are going over their head to DC, where most of the home offices are located.

Don’t let anyone try to make you feel like you are a bother because you want to file a claim for something that happened on active duty. And don’t forget the elected officials. Your Congressman or Senator know that helping veterans through inquiries makes them look good.

If your claim has been in the system a long time, an official inquiry may help to speed it up. The main thing is to never give up when you have a good claim.

2010-12-05T13:04:00.000-05:00

PTSD: Haunted By A Child

For some reason this morning I thought about the war; something that happens each day. But this time, I had been thinking about my three daughters. I remember what they looked like at age two, and that’s when the little Vietnamese girl always comes back to haunt me.

I was with 1/3 and we had just finished an operation in the Street Without Joy in late 1967. We were picked up on some road out in the boonies by trucks from B Company 7^th Motors; an outfit I would be sent to in a few more months.

Someone had a large bright red Russian flag captured during the operation and it was flying like a trophy above the lead vehicle. We slowly passed a village on the left near a sharp bend where a crowd of children came to beg food from us.

We would punch holes in the C-rat cans so they would have to eat it instead of giving it to the VC. I’m talking about many little children of all ages, dirty and starving and dressed in rags. I couldn’t imagine them giving food up to anyone, but we always poked holes in the cans.

Some of the children got so close to the trucks I thought they would get run over. And that’s when I saw the little girl in what looked like a small granny dress with colored flowers. I thought of my little sister. The girl was probably two years old. She had no shoes and very little hair. I kept thinking why a mother would let such a young child come out and beg like that…but that was an American thought process, not a Vietnam reality.

I don’t remember what food can I had in my hand, but I poked a hole in it with the c-rat can opener. We were going slowly enough for me to lean over and drop the can in front of her because she would have never been able to catch it. Others ran toward her and I yelled and startled them so she was able to grab the can. She looked up at me and half-smiled.

That’s when a boy about age thirteen ran over and punched her in the face as hard as he could and grabbed the can away from her. She flew in the air like some broken doll and sat up screaming like all babies do when hurt badly. I went into a rage as the truck sped up. I wanted to shoot that boy and pick up the little girl and hold her and make everything okay again.

In a moment, we were gone and there was nothing I could do. I would never see that village or the little girl again. I realized more than ever that there was nothing I could do about anything in that country. One act of kindness is lost against a background of terror. Reality in Vietnam was horror, and all a person could do was try to survive it.

She would probably be about forty-six if she had lived, but the odds against that were extremely high. I like to imagine she grew up and maybe came to America. That she has children of her own and they don’t have to beg for food. The little girl is always alive in my mind. She represents all the horror in the world and the personal loss I’ve felt since I left Vietnam almost forty-three years ago. Out of all the bad things I saw in country, she affects me more than anything because I could do nothing to save her.

B Company Reunion After 42 Years

2010-06-07T21:54:00.000-04:00

I was in two Marine divisions and two different outfits in Vietnam. The first half of my tour I was with H&S 1/3 of the 3rd Division.

The second half, after 1/3 came off float, was with B Company of the 7th Motor Transport of the 1st Division. B Company consisted of truck drivers, mechanics and machine gunners and not much else in between. We had road bombs and ambushes and our armor consisted of a Vietnam flack jacket and one layer of sandbags on the floor of the truck. The gunners had no cover and used open ring mounts. My best friend, Chuck Searles, was KIA on July 4, 1968 along with another Marine, David Nelson.

(I guess when compared to today, we were like cavemen as far as armor protection. We had none. I'm standing third from the right in the picture.)

On Memorial Day weekend this year, B Company got together for the first time since the war 42 years ago. I didn’t know what to expect but I recognized the three guys there from my squad right away. I was surprised how little people change in facial appearance for the most part.
We no longer had 29 and 30 R waists, and most of us had white hair and we were all 63 and older. We spent that Sunday in Kansas City at Union Square. Fifty thousand people were there to hear a symphony and to see fireworks, The conductor had us stand and told the crowd we were together for the first time since the war. The crowd cheered and applauded us. It was bizarre, considering how we were treated right after the war.

The reunion did me some good, and I felt like I had found my long lost brothers. I’m glad I went and I hope we get together again soon.

VA Charges Your Insurance

2010-04-25T16:56:00.000-04:00

Why does the VA charge my insurance company when I get treatment even though I am service-connected at 50% for PTSD and I’m supposed to receive free treatment?

The VA is authorized by law to seek reimbursement from insurance companies for all care for conditions that are not service-connected. This policy covers vets from all eras and even those being treated for non-service-connected conditions.

If you are 50% for PTSD and have health insurance, you can be treated at the VA for free for any condition, but the VA will collect from your insurance company for any problem not related to PTSD. There should never be a charge to you.The VA accepts as payment what the insurance company will pay. They are not allowed to charge your insurance for therapy related to you PTSD.

The VA has done this to me several times, and I called the insurance company and told them the bill was for a service-connected disability even though I wouldn’t have to pay anything. I’m not fond of or trying to protect my insuarnce company. But the less an insurance company pays out, the less my premium will be in the long run so I don’t want them paying for something they don’t have to pay for.

You can also visit the billing office at the VA if you know the exact date the VA charged your insurance for a service connection. They should correct it.

Veterans Appeals Court Ruling

2010-02-20T04:39:00.000-05:00

ARNOLD C. KYHN, APPELLANT,
V.
ERIC K. SHINSEKI,
SECRETARY OF VETERANS AFFAIRS, APPELLEE
(Decided January 15, 2010)

I’ve already missed VA appointments during the claim process because the Regional Office ordered an exam, but didn’t notify either myself or the local VA Hospital until after the time limit for the exam had run out.

It also works the other way. The Regional Office ordered an exam, but the local medical center didn’t send an appointment notice to the veteran until the day of the appointment had already passed. Then, the Regional Office, unaware that you had not been notified, closed your claim for not showing up for a Compensation Exam. When this happens, it can become a nightmare to straighten out, and it could possibly get worse. A very unusual ruling from the Veterans Appeals Court gives the VA a way out of claims for their own mistakes.

The Board noted that, in accordance with 38 C.F.R. § 3.655,
"[w]hen, as here, entitlement to a VA benefit cannot be established or confirmed without a current VA examination or reexamination and a claimant without good cause, fails to report for such examination scheduled in conjunction with an original compensation claim, the claim shall be rated on the evidence of record."

In this case, Mr. Kyhn says that he never received notice of his scheduled March 2006 VA audiological examination and argues that the presumption of regularity cannot be applied to the facts of his case to establish that he received notice of his scheduled examination.

Basically, the decision states that VA can deny a claim for failure to appear at an exam, whether or not the VA sent a notice of exam to the veteran ... And the VA does not have to keep a copy of the notice in their files to prove they did it, it is just assumed (presumption of regularity) they sent the veteran a notice of exam.

This can be a real setback to veterans dealing with VA claims.

Reviewing The Unemployability Percentage Rule

2010-01-13T07:33:00.000-05:00

Paragraph (a) below is the CFR requirement for unemployability. The VA and even some service organizations will tell you that you must meet those percentage requirements to be considered for unemployability. The VA will probably turn you down if you don’t meet those percentage criteria.

(a)Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities: Provided, that, if there is only one such disability, this disability shall be ratable at 60 percent or more, and that, if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more, and sufficient additional disability to bring the combined rating to 70 percent or more.

In paragraph (b) of the same section, the CFR does a complete turn around, stating you don’t have to meet the percentage requirements for unemployability if you can’t work. So if you can’t work because of service-connected disabilities and the VA turns you down because you don’t meet the percentage criteria, they violate their own law, unless they examine you again to bring your percentage up to fit the criteria in (a) if you are unable to maintain employment.

They just can’t tell you that you don’t meet the requirement and you should go away.

(b) It is the established policy of the Department of Veterans Affairs that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. Rating boards should submit to the Director, Compensation and Pension Service, for extra schedular consideration all cases of veterans who are unemployable by reason of service-connected disabilities, but who fail to meet the percentage standards set forth in paragraph (a) of this section. The rating board will include a full statement as to the veteran’s service-connected disabilities, employment history, educational and vocational attainment and all other factors having a bearing on the issue.

For example: If you are 50% for PTSD, but you can’t work because of the PTSD, then the VA must re-examine you and kick your percentage up to 70%, if the actual cause of your unemployment is PTSD.

It is up to you to file for the unemployability. It can be a drawn out process if there are other disabilities or factors involved such as alcohol, drug addiction, or physical disability. You will also probably have to be rejected by Voc Rehab for retraining. Considering the age of most Vietnam veterans with PTSD or other disabilities and a spotty employment record, Voc Rehab isn’t likely to qualify such veterans for retraining. If you have years of treatment for PTSD, the Regional Office may not turn you down on your claim for an increase. There is no sure way to tell. I went from 50% to 70% to unemployable within six weeks, after fifteen years of treatment.

Now, what may happen is the Regional Office may turn you down if you file for an increase for unemployability. Then, you appeal to the BVA. The BVA will more than likely send it back to the Regional Office for additional work. You will then be called in for an additional Comp Exam and then you are likely to get the increase. (This is the best case scenario if nothing gets screwed up with your claim along the way.) The main thing is to never give up on the claim.

Living With PTSD

2009-10-01T04:15:00.000-04:00

I believe I help a lot of veterans with my booklets and newsletters. And since I very rarely meet anyone I have helped, I sometimes have visions that maybe their lives have improved above and beyond any compensation they receive from the VA; that maybe they no longer have to live with Vietnam every day. I try to imagine that my life is much better, and the war doesn't bother me so much now. And then something will happen...

The other day on the news someone mentioned Vietnam as the war we lost, and I felt a deep rage. My wife shocked her friends at work because she says our family motto is you can never have enough ammo. Just minutes ago, I was outside on my porch during a hard rain like Nam rain. I stared at the woods, listening, and remembered what it was like to sit in the cave dark night soaked beneath a poncho while waiting to die. I haven't gotten over the war. I live with it, and I try not to think about what I might have been or what direction my life could have taken without Vietnam. And I feel nothing but anger toward the Vietnamese. Some veterans say they forgive their enemies and can move on. I can't forgive. I turn to ice inside when I think about Vietnamese.

The official Vietnam News Agency recently said that by the time Americans left at the end of 1975, three million Vietnamese had been killed, four million wounded, and two million were affected by toxic chemicals including Agent Orange. The agency said that fifty thousand children were born deformed in the first ten years after the war. It also said that a recent survey of areas around Danang found nearly 41% of the population were either dead, missing, or wounded by the time the war ended. About ten years ago, 80% of all Vietnamese were under twenty years old. Of course, they want us to pay them money. To me that brings up one question...We lost?
I don't feel sorry for them. We all lost in one way or another. The bad thing is our government gives them money with both hands, while veterans have to fight for every dime in compensation. I also read that there were 2.8 million men in-country or in combat during the war. Thirty years later there are less than a million (800,000) left alive: two million gone in 30 years. We are dying at a rate equal or faster than World War 2 or Korean vets.

One of my best friends from childhood was shot in the butt in Nam while crawling under fire on some Agent Orange defoliated hill up north. He lay there two days before choppers could get in. Years later, with no family history of cancer, he developed a tumor at the site of the bullet wound. A cancer so rare that doctors say there have only been a few cases recorded this century. The VA said Agent Orange had nothing to do with it. It moved into his lymph system. They removed his lymph system on his entire left side. He said he would shoot himself rather than go through more therapy. He just turned 51 when this happened, and he died a few months later when the artery in his leg ruptured and he bled out in front of his kids. The war is still killing us.

Another Marine veteran from the New Orleans area, who I never met, but who I had tried to help for over five years by listening and giving advice, wrote me that last Christmas and told me he went blind from diabetes. I felt like someone tore my stomach out. He was like family to me, even though we had never met. I didn't know how to comfort him, and I am angry at the system that would stall a highly decorated combat veteran for years with petty delays and unsympathetic treatment.

While reading the newspaper, I saw a section about what famous war protesters are doing now. It said Jane Fonda divides her time between her zillion acre ranch in Montana and Atlanta. That really upset me. A small town Marine like Robert Garwood, who spent his entire young life as a prisoner for fifteen years, can be branded as a traitor. But Jane Fonda, who got more men killed than any NVA unit, walks free. Oh, she did apologize once on television, an apology that meant nothing. She is an American who watched while prisoners were tortured, who sat behind enemy antiaircraft guns and acted like she was shooting down American planes. And she walks free, filthy rich off American blood.

There are constant reminders of the war all around me, but when I receive a letter from a veteran who became service-connected for PTSD because of my booklets or advice, I feel it is all worthwhile. I can almost forget that I’m 100% myself, and maybe helping other vets is my mission in life. Each combat veteran must deal with their war their own way. I have been lucky. My way is to help other vets. Maybe that’s why I survived.

Questions and Answers

2009-09-02T07:31:00.000-04:00

I grind my teeth (bruxism) really bad and have done so since I returned from RVN. My family dentist fixed me up with a night guard about 4 years ago which seems to have stabilized my condition but unfortunately the damage is already done.
When I filed my PTSD claim thru the DAV I wasn't aware that bruxism could have been brought on by my PTSD and my family dentist is willing to write a letter for me stating that in his opinion it was more likely than not that the PTSD contributed to my bruxism.
I didn't include it in my PTSD claim. Last week I went back to the DAV and had them file a claim for my bruxism.What I am trying to get is dental coverage for this condition thru the VA for my bruxism.

Grinding your teeth unless it's in your service records is going to be hard to prove. I have the same problem and I also wear a mouth guard. You can file as being secondary to PTSD, but I would be surprised if it went through. The best way to get the coverage is the increase in PTSD. If you get to 50%, then immediately file for a higher percentage. Once you get to 70%, they have to consider you for unemployability (100%) if you're not working. This would give you dental coverage. The VA only does dental work on service record injuries and 100%. But you never know. The claim could go through, but I have to answer based on the possibility of it being approved, which I don't think is good.

My service-connected hearing loss is rated at 10% and getting worse. What can I do to get a rating increase?

You can file to have the percentage increased. Problem is: hearing impairments are one of the most restrictive disabilities in the V.A. system. They don't give you any kind of a break. And their decisions with these type of claims are usually harsh and arbitrary. Be sure to get as much documentation as possible, particularly when it involves the loss of a job or some other adverse economic effect on their lives. You may also expect to probably have to use the appeals process since most of these type claims are almost always turned down by the regional office. But you can win on appeal.

I recently received 100% for unemployability, but it said nothing in my letter about being T&P. It did say that I was not scheduled for future exams and I have education and other benefits. Does this mean I’m T&P?

If your letter states you are not scheduled for a future exam and you have the education and other benefits, then you are considered T&P. No future exams means the same thing as T&P, and you would not have the other benefits if you were rated unemployable on a temporary or recall basis. Once a vet is rated unemployable, especially after age 50, it isn’t likely any future exams will change that situation unless the veteran goes to work full time.

Why can’t the Regional Office ever tell me anything about my claim when I call the 800 number?

Mainly, because the person who answers the phone call doesn’t have any more information than you do, especially if the claim is in adjudication. What you don’t want to do is make a formal inquiry. This stops the claim process cold. They have to pull your file out of line and then check to see what is going on. This can often put a claim months behind of where it should be in the system.

Is there a way to have the BVA decide my case more quickly?

If you feel you have a hardship which limits your time for the case to be resolved, you can submit a motion to advance on the docket directly to the BVA. You must show some evidence of the hardship such as a terminal illness or danger of bankruptcy or foreclosure before your case can be moved ahead of others. The BVA states that over the years, fewer than 3 out of every 20 requests have been granted. But it’s worth a shot if you have tried everything else.

Write to:
Board of Veterans Appeals (014)
Dept. of Veterans Affairs
810 Vermont Ave., NW
Washington, DC 20420

PTSD Review

2009-06-13T05:52:00.000-04:00

I am often asked why some veterans receive a “Total and Permanent” rating on their first application for PTSD compensation. I’ve also recently heard from a vet who got 100% P&T on his first claim attempt. There is no real answer to that question because receiving 100% the first time around is a rare event. But there could be several reasons in such cases when they do occur.
A veteran may have a history of never being able to hold a job or even function in society. This would warrant 100% T&P. A veteran may have been treated in the system for years without ever filing a claim, but has an obvious sporadic employment record and a diagnosis of severe PTSD. This could also possibly warrant %100 P&T.

In rare cases, a veteran could have had such a horrible wound to the head or face that no one would hire him. Although, the wound wouldn’t rate total disability, the psychological damage of having to face the war each day from the disfiguring wound and not being able to secure employment because of the wound would rate 100% T&P for PTSD. If you have had a long term history of employment and are currently employed, getting 100% on an initial claim is not going to happen.

Some veterans worry that their PTSD percentage will be cut during yearly Comp Exams. This is not likely because PTSD does not go away. It may improve on a temporary basis, but it will never go away. Once you have a PTSD percentage, it will likely go up, and never go down.
Another veteran wanted to know if it is necessary to attend therapy to receive a service connection for PTSD.

After you are service-connected, it is up to you whether you want to continue therapy. If you intend to go for an increase, therapy is important because it shows you are seeking help. If you are satisfied with your percentage, you do not have to attend therapy. Therapy is something that should be done on an individual basis according to need. If you feel further therapy won’t help you, then go only when you feel the need to talk to someone. Once again, your percentage isn’t likely to be cut because you don’t want to see a therapist constantly.

Another veteran wanted to know if Unemployable veterans can get same day treatment at a VA Medical Center for a bad tooth, ingrown toenail, or a painful boil. You can receive treatment for all these conditions, but it is different at each VA Medical Center as far as immediate treatment. It would be best to call ahead and make sure you can get in on an emergency basis, and make sure you let them know you are 100%, especially for dental work.

Also, if you are in a Voc Rehab program, you receive treatment the same as 100% while you are in the program. If this is your case, I would request documentation from the Regional Office to allow emergency treatment, because if you just go in and say you are in Voc Rehab, the Medical Center won’t treat you without an okay from the Regional Office. Since this could take a month or longer, a bad tooth won’t wait that long.

Also, if you have a dental emergency while in Voc Rehab, call your service organization officer and they should be able to help you get in right away or you may also try your Voc Rehab case worker.

Finally, for veterans filing an initial claim, it would be best before you file to go to a VA Medical Center Out-Patient Clinic and request to talk to someone about PTSD. This gets it on record that you are seeking treatment and puts you in the system. You may also be able to get an immediate diagnosis of PTSD.

(The picture above was taken at the wall this year by another Marine Nam vet and childhood friend, Bill Maag. Thomas W. Mills was our childhood friend killed by a sniper around May of 1968. We called him Bo. During visitor day in boot camp, the DI screamed at me that my brother was here to see me. I didn't have a brother but I kept my mouth shut and went to the visitor center. It was Tom, down from Pendelton and pretending to be my brother. He bought me smokes and I had about three chocolate malts before the visit was over. That visit allowed me to make through the last few weeks of boot camp. I still think of him each day.)

Individual Unemployability

2009-04-22T06:03:00.000-04:00

Under the VA Disability Compensation program, the agency can award total (100 percent) disability compensation to veterans who cannot work because of service-connected disabilities, even though their schedular rating is less than 100 percent. The VA will consider a veteran for IU benefits if the veteran has a single disability rated at least 60 percent or multiple disabilities rated at least 70 percent (with at least one disability rated at 40 percent or more) and there is some evidence that the veteran cannot work.

In some instances, veterans with lower ratings may also be evaluated for and granted IU eligibility. The VA created IU benefits in 1934. By statute, the VA is required to adopt and apply a schedule of ratings to compensate veterans for reductions in average earning capacities resulting from service-connected medical conditions. This statute calls for compensation benefits to be tied to a schedule of ratings that is to be based, “as far as practicable,” upon the average impairments of earning capacity resulting from such injuries in civil occupations. The statute does not mention individual unemployability as a basis for granting benefits.

However, VA regulations allow the agency to grant total (100 percent) disability compensation to a veteran who is unemployable due to his or her service-connected disabilities, but does not meet the requirements for a total disability using the rating schedule. Veterans can receive IU benefits when their service-connected disabilities result in their inability to obtain or retain “substantially gainful employment,” which VA defines as employment that is "ordinarily followed by (individuals without disabilities) to earn their livelihood with earnings common to the particular occupation in the community where the veteran resides.”

Finally, under its regulations, VA rating specialists are not to consider age as a factor in determining eligibility for IU benefits; veterans of any age may be determined eligible for IU benefits. VA rating specialists making IU decisions are required to determine whether the claimant is capable of obtaining or retaining substantially gainful employment. But VA regulations and guidelines do not provide the criteria and guidance that are needed to determine whether a claimant has the ability to obtain or retain substantially gainful employment or is unemployable because of his or her service-connected disabilities.

The VA has a few exceptions to its IU earnings threshold. For example, IU veterans who work in protected environments, such as a sheltered workshop or family business, may be considered to be marginally employed and still eligible for IU benefits, even when their earnings exceed the IU threshold. In addition, beneficiaries who have been receiving IU benefits for 20 years or more cannot have their benefits terminated, regardless of their earnings and employment.

(from the S-2 Report Newsletter)

PTSD Leads The List Of Mental Problems

2009-01-27T07:56:00.000-05:00

A total of 178,483 veterans who came to the VA for help were diagnosed with possible mental disorders from fiscal 2002 through September 2008, according to the January report of the VHA Office of Public Health and Environmental Hazards. Of that total, 92,998 service members, or 23 percent, were diagnosed with possible post-traumatic stress disorder, while 63,009, or 16 percent, were found to have possible depressive disorders. Other possible mental health diagnoses of returning vets, according to the VA report, were neurotic disorders (50,569 veterans), affective psychoses (35,937), non-dependent abuse of drugs (27,246) and alcohol dependence syndrome (16,217). VA notes that while the diagnoses are of war veterans, it cannot be certain that all of the conditions are war-related. This means that war does cause PTSD. The other disorders may also mean that the military is letting anyone who can pull a trigger sign up. I also don't understand (non-dependent abuse of drugs). If you have a drug problem severe enough to get service-connected for it, how is it non-dependent? Makes no sense. The conclusion should always be: War is bad for your health.

CUE (Clear and Unmistakable Error) In The Law

2008-12-05T13:07:00.000-05:00

CUE means the VA did something in your claim which is a clear violation of their own laws. One example can be when a veteran files a claim, the claim remains open until they adjudicate it. Many times, the claim will sit in a file for years before someone gets around to deciding the issues. Once in a great while, a veteran will submit a claim, and nothing will ever be done about it. Years later, the veteran may submit a new claim for the same disability. If the VA grants the claim, the effective date of the award should be the date of the old claim, not the new one.

This applies only to claims that were never adjudicated. If the VA did anything in the way of rejecting the claim, then it has been adjudicated. I often suggest to every veteran to save every letter or piece of paper they receive from the VA. That way, if you do file for the same disability years after you haven’t heard about an original claim, you have the proof in hand. If you don’t save your paper work, the VA may say you never filed, and you wont be able to prove that you did.

This situation is really not a mistake in the law, but a mistake in applying the law because they didn’t adjudicate your claim. In another case, a veteran was rated at 70% for PTSD and filed for unemployability based on the fact that he couldn’t work. Voc Rehab had turned him down for training, and he was on medication. The VA denied him the 100% rating because they said his isolation from society (typical among vets with PTSD) was self-imposed.

The Code of Federal Regulations doesn’t say anything about self-imposed isolation, as far as I know. The only way you couldn’t have self-imposed isolation is if you were in prison in solitary confinement. The VA never mentioned anything about his inability to work or anything about his work history. The total isolation and withdrawal from society due to PTSD rates 100%.
Not only did the VA violate the law by not examining him for his ability to work, they made up some fiction about his isolation. This is really grabbing at straws on their part, and is a clear violation of their own laws. This claim went to the Veterans Court of Appeals, and was remanded back to the Regional Office to be fixed. It had been going on since 1989. In the end, the veteran was granted 100% going back to 1989. He ended up getting somewhere around 60,000 in back pay.

CUE can be hard to prove, but your service organization will probably be able to spot clear violations in the law, and follow up with you. If the service organization offers to take the case to the Veterans Court of Appeals, you probably have a good chance because they wont take a case they don’t think they can win.

Any veteran rated at 70% for PTSD should file for unemployability when they can’t work.
If you’re not sure about CUE in your claim, ask someone who knows the law. And never give up!

Survivor Guilt

2008-09-27T05:46:00.000-04:00

My best friend in Nam, L/Cpl. Charles Searles, (click image to enlarge) was KIA on July 4, 1968 near An Hoa in the Arizona south of Danang during an ambush that should have killed me, too. We were supposed to rotate together on July 19, and I was going home with him to meet his parents in Burbank, close to El Toro Air Base. At the time, I didn’t think too much about it, or I didn’t let myself think too much about it. A few of the new guys in the outfit were very upset. I even saw one guy crying. I didn’t understand why because they didn’t know him well. It made me angry that they were upset because he was my best friend and I couldn’t cry for him. Years later, I realized I had been angry at myself because I couldn’t cry for him and they could. I was way short by then, had seen enough to be traumatized without really knowing it, and had become emotionally dead.

Chuck’s death hit me hard about 1978, when I was at a low point of my life. He was a better man than me. Why did he die and I still live when he would have made a success of his life and I was a failure? If I had done something different, would he still be alive? Did anything I accomplished during the war or after make any difference? Why was I alive when there was no purpose to my life? I did not expect to survive Nam, and ten years later, I wished I would have been killed there. This is called survivor guilt, a very real part of PTSD. Your dead friends take on a bigger than life image in your mind, and no matter what you do, you can never live up to the image of them your mind creates. Sometimes, if directly involved in the incident, you blame yourself for their deaths. From battalion commanders, corpsman, medics, and down to the basic fire team, all survivors of combat with PTSD suffer from survivor guilt. If carried to an extreme, survivor guilt can contribute to the overall PTSD tendency toward suicide, alcohol and drug addiction, and major health problems.

There are ways to deal with survivor guilt. Individual therapy can help. Talking about it to a therapist can give you an objective viewpoint and help you realize it wasn’t your fault your friends died and you survived. You may begin to realize that no matter what you did at the time, it wouldn’t have mattered. Try to focus on positive things you have accomplished: having children, job success, etc. Try to keep busy and find a goal. A combat veteran with PTSD and nothing to do 24 hours a day is going to have trouble dealing with depression brought on by PTSD survivor guilt. Try to convince yourself that it is over. You can never go back, and all the worry and stress over combat will not change anything.

All of this is sometimes easier said than done. I’ve been trying to do it for years, and have had some success. Everyday, at some point, I still think about Chuck, and the rest of my friends who were killed. And often, I wish I could back and do things all over again, but I’ve managed to stop most of the depression by trying to move on into the future.

excerpt from S-2 Report

PTSD Claim Tips

2008-09-12T16:18:00.001-04:00

What does the VA look for when rating a veteran for PTSD, other than being ‘crazy’?

Having PTSD does not mean you are crazy. I often have trouble making veterans understand this. You might feel like you are going crazy, but you are not. PTSD is a reaction to trauma experienced during or associated with combat. Often, the symptoms do not appear until years after the war. When someone survives a plane crash or a major disaster like an earthquake, people don’t consider them to be crazy. But they probably have the same symptoms of PTSD that many combat veterans experience. The image of combat veterans being crazy comes from the media. Every time some person barricades himself in a house, the media always tries to find out whether the guy is a Vietnam or other combat veteran. The image has been so blown out of proportion that all Nam vets are seen as bearded, bitter men wearing fatigues. It has gone so far that some of us even believe it. So, to answer the crazy part of the above question. The VA doesn’t consider you to be crazy if you have PTSD. The symptoms may include nightmares, flashbacks, startle response, inability to feel emotion, inability to function in crowds, paranoia, having to have weapons, alcohol and drug abuse, etc. but a lot of these are survivor tactics and are learned behavior required by the military. Just because they don’t go away doesn’t mean you are crazy.

What counts the most in a high PTSD percentage is your social skills in the job market. If you have held a continous job since the war, your rating will probably stay anywhere from 10% to 30%. It doesn’t matter if you hide in a closet after working hours, your rating is based on your ability to support yourself. Some veterans confuse the amount of combat one went through as deciding what percentage they will receive. Heavy combat can lead to many of the above symptoms, but does not have a bearing on the percentage you receive. Once proof of combat has been established (through service records or stressor letters), that part is over. The VA has admitted you have PTSD. Trying to use additional combat episodes will do nothing to increase your percentage. Your entire percentage is based on your ability to support yourself. So, the VA is more interested in your work history than how many symptoms you display.

I put in for an increase because my doctor agrees that my PTSD has made me unable to perform my job. The doctor says I should stay home from work. The VA, however, turned down any increase because my employer said it wasn’t PTSD and that I was just too slow. Can the VA turn me down for this reason?

No way. Rejecting your claim because of your employer’s non-medical opinion violates VA law. The VA cannot take non-medical opinion over the diagnosis of a qualified medical doctor. There is no contest here. Actually, it borders on being ridiculous. You will win on appeal because the VA cannot violate its own laws. I have seen other cases when Vet Center counselors have submitted statements saying a veteran has PTSD, but the VA threw out such statements as non-medical opinion because the Vet Center counselor was not a doctor. Yet, I have seen the same counselor submit a statement saying a veteran does not have PTSD, and the VA turned down the claim because of the counselor’s opinion, when it favored the VA. Either way, such use of non-medical opinions are wrong, and should not have a bearing on PTSD claims. If you are ever turned down under the same circumstance, fight it. You will win.

Combat PTSD Site

AXIS: What Does All That Stuff Mean?

2008-08-26T06:21:00.000-04:00

You’ve probably seen the Axis on your VA paperwork at some point. Most vets don’t have any idea what it means. I did some checking with an expert in the field and the following information was passed on to me.
AXIS
First of all the axis are all parts of the diagnostic system of the American Psychiatric Association. This system did not come down with Moses from Mt. Sinai, it was developed by a bunch of committees and is periodically revised in a book called the Diagnostic and Statistical Manual.
The idea of multiaxial diagnosis is to be thorough and incorporate medical and social factors into mental health diagnoses.

Axis I and Axis II diagnoses have very specific criteria.
The theory is that different clinicians could use these criteria and come up with the same diagnosis for a given individual. Often the criteria are kind of like a Chinese restaurant menu (choose three from column A and 2 fromColumn B...) The five axis are:
Axis I
This is where primary psychiatric diagnoses are written. Axis I diagnoses include: Depression, PTSD, Alcohol Dependence and many others. You can have more than one disorder on each axis.

Axis II
This is where "personality disorders" are coded. Personalitydisorders are lifelong problematic patterns of behavior and psychological functioning. An example is Narcissistic Personality Disorder. Personality disorders are viewed as more difficult to change than Axis I disorders.
(It can be possible, from my experience when dealing with veterans, to have PTSD and a personality disorder at the same time, the VA will not grant a PTSD claim if a personality disorder was pre-existing.)
Axis III
This is where physical (medical) problems are listed.
Axis IV
This is a list of current psychsocial stressors. Examples might include: unemployment, family conflict, homelessness.
Axis V
This is where a "Global Assessment of Functioning" (GAF) Score is written. The GAF is a number between 0 and 100 which describes the individual's overall level of functioning in life. There are specific criteria clinicians are supposed to use when assigning a GAF score to a veteran.
A GAF of 50 indicates serious problems.Following is a quotation from DSM-IV describing a GAF in the range of 41 to 50.
"Serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting) OR any serious impairment in social,occupational or school functioning ( no friends, unable to maintain a job.)"
Note that someone could be stable and still get a GAF of 50. For example, someone with chronic PTSD who isolates, does not work, and has few social contacts could be accurately given a GAF of 50 and might maintain this for years. Clinicians are expected to use it as part of diagnosis. It has been used as an outcome measure to measure the effectiveness of programs. However, some in the field think it is not a great measure for this purpose because it often utilized in a subjective way. The objective information describing how to assign scores is often ignored, meaning there could be a big difference in scores. The GAF can also change on a daily basis.

Hopefully, this will help you understand what's going on when you see a reference to Axis on your paperwork.

New Review Of Michael In Hell

YS Gazelle Books

Sleep Apnea

2008-08-18T05:24:00.000-04:00

Two of the major indicators for sleep apnea are neck size and body mass index. Perhaps as many as 75% of professional football players, and many college and even high school players, qualify for the neck size indicator, which is 18 inches. And despite being in sensational football condition, many qualify for the body mass index indicator, which is 30 and above.

I have a large neck and head. It’s always been hard to really hurt me by hitting me in the head, which had made me the topic of many jokes during my childhood. I’ve had sleep apnea for years and I use the CPAP, which can be a real pain. For veterans with sleep apnea who don’t have a 50% or more service connection, being diagnosed with sleep apnea can be a big expense if you lack health insurance.

The machine cost about $2000 and the doctor visits to determine if you have sleep apnea probably cost about the same. I got my machine through private health insurance because I didn’t know the VA could help me with the sleep disorder. Now, I see the chest doctor there and they replace my mask and heated water contained and check my machine when necessary. I don’t hold my breath at night anymore, at least, most of the time, but my sleep isn’t any better. I still wake up every few hours, and I don’t sleep anymore than I did without the mask. This tells me that a lot of my problem is Nam related because my survival instinct never really shuts down. I usually catnap during the day without the mask.

The mask takes time to become routine and makes me feel like some weird astronaut. The only other alternative because the base of my tongue is huge was an operation that isn’t guaranteed to work. The doctor also told me it would make my chin pointed because they would have to remove half of my chin and pull the pieces together. They said I would probably look different. That went over big. At my age, I’m kind of used to my own weird face and I didn’t care to walk around looking like somebody else. So I passed on any kind of surgery.

I did meet a guy who had the surgery, and it worked for awhile but now he has problems again. It’s best just to get the mask and CPAP and deal with it. Then, if you don’t like it or don’t want to use it, you have the option to stop. But if you have the symptoms get checked out because untreated sleep apnea can cause other health problems.