My PCM doesn'tlike what my C&P mental health exam says...

Tin3yT3ch

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Hello All,

I've been on this website everyday for about 6 months. I've studied almost every thread imaginable so I haven't been caught off guard by any steps in my MEB, you guys have kept me informed. So here's my background: After 9yrs of being seen by MH I was diagnosed with Bipolar 1 disorder. I started taking my medication seriously (I'd been offered medication before but didn't think I was that far gone). I've been better than ever, however because of the diagnosis and my history of hospitilizations they started my MEB. Everything has been running smoothly till this point. My Peblo recieved my results from my C&P exams and forwarded them to my PCM (my psychiatrist). I happened to have my weekly appt with him the next day. His first question was "How long was your MH exam", I told him 30-45mins...It was just me giving a synopsis of my life till this point, and I think I articulated myself well. The VA examiner apprently marked me as-

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 medication

He believes I'm more at this level-
Occupational and social impairment with reduced reliability and productivity


Now I know this result will ultimately determin my VA ratings and as of now I'm looking at a seperation after 10yrs, but I'm ok with that. In fact I'd prefer it, but will my PCM beable to fight this or will he just add his opion via my NARSUM before it's forwarded to AFPC for my fit/unfit determination. I'd ask my PEBLO but we only communicate via email and it takes her weeks to respond. I don't think I'll hear from her again until it's time for me to sign. Any insight would be appreciated! thanks!!
 

Sullysull48

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Did your C&P examiner list any of these on the DBQ?
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)
Reason I am asking. When I filed my claim for PTSD , examiner gave me the same as you, but listed the behavior part. I was awarded 30%.
 

oddpedestrian

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Yea this will be 30% or lower. That's the point you can't come across as intelligent or well put together for MH exams they are judging your looks, speech patterns, vocabulary, hygiene et cetera if you come across very articulate then that justifies examiners election that most of your symptoms are controlled by medication which is typically for BP claims. That's why I recommend that you convey your worst day on the day of the C&P exam not one of your best.
 

Tin3yT3ch

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Thanks guys,

She marked me for the following:
Depressed mood, Anxiety, Chronic Sleep impairment, Difficulty in adapting to stressful circumstances, including work or a worklike setting, Persistent danger of hurting self or others.

My psychiatrist agrees that I'm doing a lot better on medication however I have a know pattern of stopping, and with the amount I take now stopping would be detrimental. I know I'm not supposed to stop btw I just get ahead of myself sometimes and before i know it I'm back where I started. I see no where I F'd up by telling her I was much better now. I was going by how I'd been feeling lately, not my worse day.
 

eaglesnation!

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I was told I may get Medically retired do to my MEB being 2 different diagnoses but they took one diagnose off and just Med boarding me for Bipolar II disorder. So now may get medically separated but its still possible that I get medically retired.
What should I expect? I finished both my C&P appointments , waiting on the decision for IPEB the VA mental health stated
depression, anxiety, suspiciousness, panic attacks more than once a week, chronic sleep impairment, mild memory loss,
flattened affect, impaired abstract thinking, disturbances of motivation mood, difficulty maintaining effective work and social relationships, difficulty adapting to stressful circumstances(including work or work like setting), Impaired impulse control, such as unprovoked irritability with periods of violence, and persistent delusion or hallucination.
 

oddpedestrian

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I was told I may get Medically retired do to my MEB being 2 different diagnoses but they took one diagnose off and just Med boarding me for Bipolar II disorder. So now may get medically separated but its still possible that I get medically retired.
What should I expect? I finished both my C&P appointments , waiting on the decision for IPEB the VA mental health stated
depression, anxiety, suspiciousness, panic attacks more than once a week, chronic sleep impairment, mild memory loss,
flattened affect, impaired abstract thinking, disturbances of motivation mood, difficulty maintaining effective work and social relationships, difficulty adapting to stressful circumstances(including work or work like setting), Impaired impulse control, such as unprovoked irritability with periods of violence, and persistent delusion or hallucination.
Can't say the question on block four of the exam "social and occupational impairment" gives the most likely answer.
 

tony292

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That’s 50%. But she has some symptoms that warrant a higher rating, so I’d recommend a VARR.
 

whatsuprabbit

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Yea this will be 30% or lower. That's the point you can't come across as intelligent or well put together for MH exams they are judging your looks, speech patterns, vocabulary, hygiene et cetera if you come across very articulate then that justifies examiners election that most of your symptoms are controlled by medication which is typically for BP claims. That's why I recommend that you convey your worst day on the day of the C&P exam not one of your best.
I actually beg to differ. I was referred to MEB for Bipolar 1 with psychotic features postpartum onset and during my C&P exam I conducted myself as I would any day, very well put together. I never have exhibited signs or symptoms of Bipolar Disorder previous to having my son. I was very upfront and honest with the psychiatrist. I told her how much I have improved since my psychotic episode. Then to my surprise I received a proposed rating of 100%. But that's just my experience....
 

chaplaincharlie

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If you believe your rating is incorrect (when it comes back via the PEBLI) you can file a VARR. Your rating will be 50% based on what you wrote about the VA report. The narrative of your diseases describes something higher than 50%.
 

oddpedestrian

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I actually beg to differ. I was referred to MEB for Bipolar 1 with psychotic features postpartum onset and during my C&P exam I conducted myself as I would any day, very well put together. I never have exhibited signs or symptoms of Bipolar Disorder previous to having my son. I was very upfront and honest with the psychiatrist. I told her how much I have improved since my psychotic episode. Then to my surprise I received a proposed rating of 100%. But that's just my experience....
This is not the standard in any sense but I'm not contesting that it doesn't happen and sometimes too often. It's the same reason we get posts about Veterans being denied SSDI when they are rated 100% from the VA, if you investigate each of those Veterans files you will see that the likelihood of their 100% rating not being substantiated by the Progress Notes as the root cause of the SSDI denial things start to become a little clearer about errors at C&P exams. The examiner checks they reviewed the file but doesn't the rater may see that the file doesn't match what the examiner wrote but doesn't kick it back and the Veteran gets a percentage that doesn't accurately reflect their impairment (too high or low).
 

12Mustang05

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I actually beg to differ. I was referred to MEB for Bipolar 1 with psychotic features postpartum onset and during my C&P exam I conducted myself as I would any day, very well put together. I never have exhibited signs or symptoms of Bipolar Disorder previous to having my son. I was very upfront and honest with the psychiatrist. I told her how much I have improved since my psychotic episode. Then to my surprise I received a proposed rating of 100%. But that's just my experience....
If you don’t mind me asking were you tdrl or p & t 100 percent from the va. Also do you remember what they gave you on c & p exam for occupational impairment I would assume the total impairment description of that gave you 100 rating but you never know just curious I’m waiting on ratings for bipolar as well.
 

whatsuprabbit

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If you don’t mind me asking were you tdrl or p & t 100 percent from the va. Also do you remember what they gave you on c & p exam for occupational impairment I would assume the total impairment description of that gave you 100 rating but you never know just curious I’m waiting on ratings for bipolar as well.
So from what I've gathered the 100% isn't permanent, since there's a chance of improvement. On my C&P exam I was marked occupational and social impairment with deficiencies in most areas, such as work school, family relations, judgement, and thinking and/or mood. I hope everything works out in your favor!
 

12Mustang05

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So from what I've gathered the 100% isn't permanent, since there's a chance of improvement. On my C&P exam I was marked occupational and social impairment with deficiencies in most areas, such as work school, family relations, judgement, and thinking and/or mood. I hope everything works out in your favor!
Thanks and the same.
 

heathro1281

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When do you file for a VARR? After you receive ratings, correct? I declined an IMR and my package was forwarded to AFPC for fit/unfit determination, still awaiting ratings.
 
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