Military doctors who i have been seeing for over a year say Severe PTSD VA C&P doc says not PTSD??

Gba19

Registered Member
#1
So i have my Military doctors who say Tbi and serve PTSD among other things ie Ankylosing spondylitis also taking humeria, post traumatic headache syndrome, post concussion syndrome, transit alteration of awareness, chronic lower back pain, cervicalgia, intervertebral disc degeneration, limbosacral. That is my referred conditions. So i go to my mental health C&P and not to be one of those he was mean to me blah blah persons but the guy was very rude and to be frank kinda wired i felt like i was about to be on silence of the lambs kinda feeling. But he said vet doesn’t meet PTSD under dsm-5 vet has another mental diagnosis. He stated i have #1 Unspecified Trauma and stressor related disorder isd code F43.9 he goes on to say yes i have a TBI i have occupational and social impairments with occasional decrease in work efficiency and intermittent periods of inability to perform although generally functions satisfactory. Then he goes on to say as noted below psychometric screening indicated the presence of negative response bias it is not possible to determine the extent of congitive impairment at this time. Now i know because my military provider(s) where not to happy with his opinion what kinda that means something to the effect i was lying and over stating my symptoms. Which i don’t care if he says i have PTSD or not i don’t care duebto the fact i know i have something and have been getting help and i have nothing but great things to say about my military doctors they have helped me so much and got me my service dog (LOKI) who has helped me re connect to my wife and kids. So i can give 2 @&@“ what creeper from the VA says. But for him to call me a LIER is kinda crazy. What happens when my multiple military providers say one thing and the Va says another? Sorry for the rant i appreciate any feedback.
 

oddpedestrian

PEB Forum Veteran
Registered Member
#3
It is so dirty when they use the psychometric screening to state that your self-reports cannot be taken seriously, even if its true he must then read the clinical notes of your docs who are responsible with accurately diagnosing the condition beyond the inconclusive screening, of course, the bias doc ignores that evidence and just states you have no credibility. Don't fret it but you mentioned something that you need to act immediately on and that is him stating you do not have PTSD based off of DSM-V. The new DBQ clearly states to base it off of DSM-IV, not V that's because DSM V eliminated the fear-based criteria for being diagnosed with PTSD. The VA updated their new PTSD DBQ in May this year and it clearly instructs the examiner to still based their opinion off of DSM-IV for PTSD. If the examiner used V at all that's grounds for a new C&P exam or better yet have your military doc fill out the PTSD DBQ and submit it via ebenefits.
 

euphonix

PEB Forum Veteran
Registered Member
#4
It is so dirty when they use the psychometric screening to state that your self-reports cannot be taken seriously, even if its true he must then read the clinical notes of your docs who are responsible with accurately diagnosing the condition beyond the inconclusive screening, of course, the bias doc ignores that evidence and just states you have no credibility. Don't fret it but you mentioned something that you need to act immediately on and that is him stating you do not have PTSD based off of DSM-V. The new DBQ clearly states to base it off of DSM-IV, not V that's because DSM V eliminated the fear-based criteria for being diagnosed with PTSD. The VA updated their new PTSD DBQ in May this year and it clearly instructs the examiner to still based their opinion off of DSM-IV for PTSD. If the examiner used V at all that's grounds for a new C&P exam or better yet have your military doc fill out the PTSD DBQ and submit it via ebenefits.
I'm curious, besides the DBQ, has there been a directive from either the VA or Congress mandating that PTSD not be diagnosed in accordance with the DSM-5? I ask because the VA and the DoD has transitioned to the DSM-5 and the VA is mandated by law in 38 CFR to utilize the DSM-5 when diagnosing mental disorders and applying the VASRD. If the VA is actively utilizing the DSM-IV to diagnose PTSD without congressional approval it would appear that they are in violation of the law.

https://www.law.cornell.edu/cfr/text/38/4.125
 

chaplaincharlie

PEB Forum Veteran
Registered Member
#5
Psychometric screening is useful, but not the complete answer! An acquaintance of mine was performing screenings for a large city police department. The candidate comes in for her in person interview. After the introductions and small talk she say you probably think I'm paranoid. The therapist says, what makes you think I think your paranoid. She replies that test with questions like; someone knows my every move, someone is always following me.... (she had scored vere high on paranoida on the MMPI-2, scale 6). She goes on to explain she is in the middle of a divorce and her wealthy husband has a private detective following her. She walks over to the window and points to a car with a man sitting in the driver's seat. She tells the therapists when I leave, he will follow me. The therapist, picks up the phone and calls dispatches to have patrol interview the man. Sure enough he is a private investigator. Psychometrics helps a clinician look in the right areas, they don't look for the provider.
 

oddpedestrian

PEB Forum Veteran
Registered Member
#6
I'm curious, besides the DBQ, has there been a directive from either the VA or Congress mandating that PTSD not be diagnosed in accordance with the DSM-5? I ask because the VA and the DoD has transitioned to the DSM-5 and the VA is mandated by law in 38 CFR to utilize the DSM-5 when diagnosing mental disorders and applying the VASRD. If the VA is actively utilizing the DSM-IV to diagnose PTSD without congressional approval it would appear that they are in violation of the law.

https://www.law.cornell.edu/cfr/text/38/4.125
Only the final rule published by the VA in 2010 https://www.federalregister.gov/doc...erminations-for-posttraumatic-stress-disorder. I have spoken to a senior rater at the VA and they claim they are allowed to apply DSM-IV to PTSD MH claims only and that other mental health claims must fall under DSM-V. I still dont see how this is possible because the newly realsed DBQ that covers mental health other than PTSD also mentions DSM-IV for diagnostic codes purposes. I doubt the VA can backtrack at this point the final rule came out because they use to investigate every incident a veteran claimed happen oversees before granting PTSD which took years because of coordination with the DOD. If the VA didn't come out with the final rule Congress had already proposed a bill eliminating the stressor requirement and making any veteran that went overseas and was eligible for combat pay could claim PTSD. https://www.congress.gov/bill/112th-congress/house-bill/2419. The final rule relies heavily on DSM-IV I guess they are sticking with it any time an administrative agency releases a final rule they don't change unless through a congressional bill or court order.
 

euphonix

PEB Forum Veteran
Registered Member
#7
Only the final rule published by the VA in 2010 https://www.federalregister.gov/doc...erminations-for-posttraumatic-stress-disorder. I have spoken to a senior rater at the VA and they claim they are allowed to apply DSM-IV to PTSD MH claims only and that other mental health claims must fall under DSM-V. I still dont see how this is possible because the newly realsed DBQ that covers mental health other than PTSD also mentions DSM-IV for diagnostic codes purposes. I doubt the VA can backtrack at this point the final rule came out because they use to investigate every incident a veteran claimed happen oversees before granting PTSD which took years because of coordination with the DOD. If the VA didn't come out with the final rule Congress had already proposed a bill eliminating the stressor requirement and making any veteran that went overseas and was eligible for combat pay could claim PTSD. https://www.congress.gov/bill/112th-congress/house-bill/2419. The final rule relies heavily on DSM-IV I guess they are sticking with it any time an administrative agency releases a final rule they don't change unless through a congressional bill or court order.
This document was published in 2010 and the DSM-V was published in 2013. The VA implemented the DSM-V on August 4, 2014. If they are still going by this 2010 document they are likely breaking the law (38 CFR) and their own regulations. This wouldn't actually be all that surprising since the VA has a long history of ignoring established law and regulation.

Based on the Compensation and Pension Manual Rewrite, it appears that the DSM-IV criteria are allowed to be used if they benefit the veteran. Otherwise the DSM-V criteria have to be used.
 

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