EBenefits Question

Russ35057

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
can anyone tell me what this means?

for mitigation ( with QRT )

I submitted for an increase and this is one of the notes... I'm literally 1 percentage point away from a 100% rating before the increase request.
 

RonG

Super Moderator
Staff Member
PEB Forum Veteran
Registered Member
can anyone tell me what this means?

for mitigation ( with QRT )

I submitted for an increase and this is one of the notes... I'm literally 1 percentage point away from a 100% rating before the increase request.
Guess:
Quality Review Team (QRT)
Mitigation: A lessening....the process or result of making something less severe, dangerous, painful, ...


--->VA LINK

Ron

added:
Never heard those terms used by the VA previously, but within the linked info:

If the QRT...Then ...
upholds the deferral the claims processor takes the action directed in the deferral.
finds the deferral to be in error
  • the claims processor’s supervisor will resolve the deferral from VBMS using the “Mitigate” button, and
  • the claims processor takes the necessary actions to move the claim to the next stage of processing.

Note: All actions must be completed within three business days following QRT review.
 

Russ35057

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
I was hoping that since once again they didn't service connect PTSD that it went for a disagreement since the incidents that happened to cause my PTSD were during the last 10 years I was on AGR orders
 

Russ35057

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
well that one was closed... still the same ratings.... denied again i guess.
 

Guardguy11

Super Moderator
Staff Member
PEB Forum Veteran
Registered Member
Good grief. That is incredibly frustrating to not only be 1% away from 95%, but also to know you have other conditions that should be rated. Have you tried seeking legal counsel?
 

Russ35057

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
not yet. my MEB is still playing out too and I've had to file for increases with my anxiety and depression that definitely are 70% and not 30 I'm currently rated at...
 

Russ35057

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
and I think the VA is getting mad at me... whenever I have a new thing show up I file.... this one has come up after a recent sleep study.... debating on pulling the trigger...

Sleep dysfunction with arousal disturbance (SCT 442176004)
 

Russ35057

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
@Guardguy11 here's the write up on the mental health -
SECTION I:


----------


1. Diagnostic Summary
Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria
based on today's evaluation?
[X] Yes [ ] No

2. Current Diagnoses
a. Mental Disorder Diagnosis #1: MDD, recurrent, moderate
Comments, if any:
Veteran is 30% SC for MDD. Veteran's symptoms began while in
service and have continued. He does not meet criteria for PTSD. His
depression is caused by his experiences in service.

Mental Disorder Diagnosis #2: Personality disorder NOS

b. Medical diagnoses relevant to the understanding or management of the
mental health disorder (to include TBI): back pain, sleep apnea

3. Differentiation of symptoms

a. Does the Veteran have more than one mental disorder diagnosed?
[X] Yes [ ] No

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

[ ] Yes [X] No [ ] Not applicable (N/A)
If no, provide reason:
symptoms are interrelated and impossible to differentiate

c. Does the Veteran have a diagnosed traumatic brain injury (TBI)?
[ ] Yes [ ] No [X] Not shown in records reviewed

4. Occupational and social impairment

a. Which of the following best summarizes the Veteran's level of occupational
and social impairment with regards to all mental diagnoses? (Check only one)

[X] Occupational and social impairment with deficiencies in most areas,
such as work, school, family relations, judgment, thinking and/or mood

b. For the indicated occupational and social impairment, is it possible to
differentiate which impairment is caused by each mental disorder?

[ ] Yes [X] No [ ] Not Applicable (N/A)


If no, provide reason: symptoms are interrelated


c. If a diagnosis of TBI exists, is it possible to differentiate which


occupational and social impairment indicated above is caused by the TBI?

[ ] Yes [ ] No [X] Not Applicable (N/A)


SECTION II:


-----------


Clinical Findings:
1. Evidence Review

Evidence reviewed (check all that apply):


[X] VA e-folder
[X] CPRS
[X] Other (please identify other evidence reviewed):

I conducted a thorough psychosocial evaluation with the veteran.

4. PTSD Diagnostic Criteria

Note: Please check criteria used for establishing the current PTSD diagnosis.

Do NOT mark symptoms below that are clearly not attributable to the Criterion

A stressor/PTSD. Instead, overlapping symptoms clearly attributable to other

things should be noted under #7 - Other symptoms. The diagnostic criteria

for PTSD, referred to as Criterion A-H, are from the Diagnostic and

Statistical Manual of Mental Disorders, 5th edition (DSM-5).

Criterion A: Exposure to actual or threatened a) death, b) serious injury,

c) sexual violence, in one or more of the following ways:

[X] No criterion in this section met.


Criterion B: Presence of (one or more) of the following intrusion symptoms

associated with the traumatic event(s), beginning after the

traumatic event(s) occurred:


[X] No criterion in this section met.


Criterion C: Persistent avoidance of stimuli associated with the traumatic


event(s), beginning after the traumatic events(s) occurred,


as evidenced by one or both of the following:


[X] No criterion in this section met.


Criterion D: Negative alterations in cognitions and mood associated with


the traumatic event(s), beginning or worsening after the


traumatic event(s) occurred, as evidenced by two (or more) of


the following:

[X] Persistent negative emotional state (e.g., fear, horror,


anger, guilt, or shame).


[X] Markedly diminished interest or participation in


significant activities.


[X] Feelings of detachment or estrangement from others.


[X] Persistent inability to experience positive emotions


(e.g., inability to experience happiness, satisfaction, or


loving feelings.)


Criterion E: Marked alterations in arousal and reactivity associated with


the traumatic event(s), beginning or worsening after the


traumatic event(s) occurred, as evidenced by two (or more) of


the following:


[X] Irritable behavior and angry outbursts (with little or no


provocation) typically expressed as verbal or physical


aggression toward people or objects.


[X] Problems with concentration.


[X] Sleep disturbance (e.g., difficulty falling or staying


asleep or restless sleep).


Criterion F:


[X] Duration of the disturbance (Criteria B, C, D, and E) is


more than 1 month.


Criterion G:


[X] The disturbance causes clinically significant distress or


impairment in social, occupational, or other important


areas of functioning.


Criterion H:


[X] The disturbance is not attributable to the physiological


effects of a substance (e.g., medication, alcohol) or


another medical condition.
Criterion I: Which stressor(s) contributed to the Veteran's PTSD


diagnosis?:


[X] No criterion in this section met.


5. Symptoms


-----------


For VA rating purposes, check all symptoms that actively apply to the


Veteran's diagnoses:


[X] Depressed mood


[X] Anxiety


[X] Suspiciousness


[X] Panic attacks more than once a week


[X] Chronic sleep impairment


[X] Mild memory loss, such as forgetting names, directions or recent


events


[X] Disturbances of motivation and mood


[X] Difficulty in establishing and maintaining effective work and social


relationships


[X] Difficulty in adapting to stressful circumstances, including work or a


worklike setting


[X] Inability to establish and maintain effective relationships


[X] Suicidal ideation


[X] Impaired impulse control, such as unprovoked irritability with periods


of violence


[X] Persistent delusions or hallucinations


[X] Neglect of personal appearance and hygiene


[X] Intermittent inability to perform activities of daily living,


including maintenance of minimal personal hygiene
 
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