Need Advice on PEB 199

I had a disability rating of 30% for panic disorder from 2007 after returning home from Iraq I put in a claim for PTSD in 2010. It has taken almost 3 years for them to make a decision and during that time my symptoms have me being boarded out of the military. They are offering me 40% permanent retirement. I am getting 10% for a neck injury (Shot in Face in Iraq). All the VA did for the PTSD is change the name of my Panic Disorder to PTSD with Panic Disorder, and then state this:

We reviewed the evidence received and determined your service-connected condition hasn't
increased in severity sufficiently to warrant a higher evaluation. The VA examiner related the
stressor to fear of hostile military or terrorist activity and that the VA examiner linked the PTSD
symptoms to the stressor. When more than one mental health condition has been diagnosed and
are service connected, the symptoms of each condition tend to overlap. Because of this, all
symptoms of each mental health condition are considered in one evaluation.

Hasn't increased! are they insane my whole life is miserable! I've been in and out of PTSD programs Doctors different meds trying to get a handle on this! They say if I ask for a reconsideration I risk loosing everything, so they are forcing me to play the lottery with what future I can still have.
 
Other than the PTSD and the neck injury from the GSW, do you have any other conditions? The rating for behavioral health is derived from your GAF score.

You may want to have a vetrans service organization take a look at the evaluation to make sure that they have the GAF score correct based upon evaluation.

Out of curiosity have you been seeking active and regular treatment for PTSD (I read that you have stated you have been in-and-out) I am more concerned by regular type appointments.

My suggestion to your is to seek out your local Vet Center fro counseling. Call 1-800-927-8387 (WAR-VETS)
 
Other than the PTSD and the neck injury from the GSW, do you have any other conditions? The rating for behavioral health is derived from your GAF score.

You may want to have a vetrans service organization take a look at the evaluation to make sure that they have the GAF score correct based upon evaluation.

Out of curiosity have you been seeking active and regular treatment for PTSD (I read that you have stated you have been in-and-out) I am more concerned by regular type appointments.

My suggestion to your is to seek out your local Vet Center fro counseling. Call 1-800-927-8387 (WAR-VETS)

There is some confusion with my GAF score in early 2010 it was listed as 79 but after a couple of programs at the VA it is 59 I believe. I work full time and I am a single father of 4 kids. The VA is not very accommodating to what I can do. I have quickly burned thru all my vacation, personal hours and sick leave. My symptoms really started majorly after a 12 week program, I was doing fine by avoidance I can't explain whats happened. My employer has been very supportive but even they have limits. I regularly see the VA Psychiatrist I have become a test subject for different meds.
 
Link up with the Vet Center. They are a great organization that phenominal behavioral health resources.

I noticed you have mentioned 40% permanent retirement, is this from the DoD? The VA does not offer retirement but rather compensation and pension for injuries that were incurred during military service and/or were aggravated during military service.

Can you please further explain being boarded out of the Military? Was this a MEB/PEB or an adminstrative discharge. If it was MEB/PEB were you TDRL? I am trying to get a better picture of what has taken place.
 
Link up with the Vet Center. They are a great organization that phenominal behavioral health resources.

I noticed you have mentioned 40% permanent retirement, is this from the DoD? The VA does not offer retirement but rather compensation and pension for injuries that were incurred during military service and/or were aggravated during military service.

Can you please further explain being boarded out of the Military? Was this a MEB/PEB or an adminstrative discharge. If it was MEB/PEB were you TDRL? I am trying to get a better picture of what has taken place.

The 40% is from the DOD I just recieved my 199 for the PEB and was wondering if I should risk asking them for a reconsideration or would I be endangering what I will already recieve.
 
If you feel the rating is not justified and you have new medical evidence to submit then a reconsideration is not out of the question.

I would have the Vet Center do a BH assesment then see what they come up with. Have a VSO take a look at everything and see if you have the medical evidence to support a ratings increase from the VA.

If it were me, I would contact Jason Perry on here and have him work the case.
 
The GAF appears no where in the VARSD; thus, having no direct impact on ratings.

Was your PTSD determined unfitting by the PEB? What was your initial overall rating from PEB?
 
The GAF score directly translates to the VASRD rating schedule. The lower your GAF score the higher rating comes back. With a GAF of 59 you are nearly at 60 which would then put you at the moderate state and thus warrant a 30% rating.

Here are the GAF scores and methodology behind them:
100
|
91
Superior functioning in a wide range of activities, life’s problems never seem to get out of hand, is sought out by others because of his or her many positive qualities. No symptoms.
90
|
|
81
Absent or minimal symptoms (e.g., mild anxiety before an exam), good functioning in all areas, interested and involved in a wide range of activities, socially effective, generally satisfied with life, no more than everyday problems or concerns (e.g., an occasional argument with family members).
80
|
|
71
If symptoms are present, they are transient and expectable reactions to psychosocial stressors (e.g., difficulty concentrating after family argument); no more than slight impairment in social, occupational, or school functioning (e.g., temporarily falling behind in schoolwork).
70
|
|
61
Some mild symptoms (e.g., depressed mood and mild insomnia) OR some difficulty in social, occupational, or school functioning (e.g., occasional truancy, or theft within the household), but generally functioning pretty well, has some meaningful interpersonal relationships.
60
|
|
51
Moderate symptoms (e.g., flat affect and circumstantial speech, occasional panic attacks) OR moderate difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peers or co-workers).
50
|
|
41
Serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting) OR any serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job).
40
|
|
|
31
Some impairment in reality testing or communication (e.g., speech is at times illogical, obscure, or irrelevant) OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood (e.g., depressed man avoids friends, neglects family, and is unable to work; child frequently beats up younger children, is defiant at home, and is failing at school).
30
|
|
21
Behavior is considerably influenced by delusions or hallucinations OR serious impairment, in communication or judgment (e.g., sometimes incoherent, acts grossly inappropriately, suicidal preoccupation) OR inability to function in almost all areas (e.g., stays in bed all day, no job, home, or friends)
20
|
|
11
Some danger of hurting self or others (e.g., suicide attempts without clear expectation of death; frequently violent; manic excitement) OR occasionally fails to maintain minimal personal hygiene (e.g., smears feces) OR gross impairment in communication (e.g., largely incoherent or mute).
10
|
1
Persistent danger of severely hurting self or others (e.g., recurrent violence) OR persistent inability to maintain minimal personal hygiene OR serious suicidal act with clear expectation of death.
0
Inadequate information.

And here is the rating guidlines from the VASRD


General Rating Formula for Mental Disorders:



Total occupational and social impairment, due to such symptoms as:

gross impairment in thought processes or communication;

persistent delusions or hallucinations; grossly inappropriate

behavior; persistent danger of hurting self or others; intermittent

inability to perform activities of daily living (including maintenance

of minimal personal hygiene); disorientation to time or place; memory

loss for names of close relatives, own occupation, or own name .................... 100



Occupational and social impairment, with deficiencies in most areas,

such as work, school, family relations, judgment, thinking, or mood,

due to such symptoms as: suicidal ideation; obsessional rituals

which interfere with routine activities; speech intermittently illogical,

obscure, or irrelevant; near-continuous panic or depression affecting

the ability to function independently, appropriately and effectively;

impaired impulse control (such as unprovoked irritability with periods

of violence); spatial disorientation; neglect of personal appearance and

hygiene; difficulty in adapting to stressful circumstances (including

work or a worklike setting); inability to establish and maintain

effective relationships ........................................................................................ 70



Occupational and social impairment with reduced reliability and

productivity due to such symptoms as: flattened affect; circumstantial,

circumlocutory, or stereotyped speech; panic attacks more than once

a week; difficulty in understanding complex commands; impairment

of short- and long-term memory (e.g., retention of only highly learned

material, forgetting to complete tasks); impaired judgment; impaired

abstract thinking; disturbances of motivation and mood; difficulty in

establishing and maintaining effective work and social relationships ............... 50



Occupational and social impairment with occasional decrease in work

efficiency and intermittent periods of inability to perform occupational

tasks (although generally functioning satisfactorily, with routine

behavior, self-care, and conversation normal), due to such symptoms

as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or

less often), chronic sleep impairment, mild memory loss (such as

forgetting names, directions, recent events) ...................................................... 30



Occupational and social impairment due to mild or transient symptoms

which decrease work efficiency and ability to perform occupational

tasks only during periods of significant stress, or; symptoms controlled

by continuous medication .................................................................................. 10



A mental condition has been formally diagnosed, but symptoms are not

severe enough either to interfere with occupational and social

functioning or to require continuous medication.................................................. 0
 
Gsfowler, I do agree that ratings for behavioral health conditions ultimately comes down to the level of functioning (in all aspects), or lack there of, by the SM; however, in my humble opinion, the direct correlation (between GAF and VARSD) is not strong enough to say, "the rating for behavioral health is derived from your GAF score." :) By the time the GAF score gets to the VA, it's simply a number--the score or test isn't broken down in a detailed manner showing specifically how each question was answered by the SM.

I guess I'm trying to say that the GAF score is only one piece to the puzzle...and I would argue a small piece. :)
 
The C&P evaluation from behavioral health has a GAF score, the report that is filed adresses each of the fileds required for the percentage rating. The GAF score is just a number however it does directly relate the the percentage of disability. the GAF score is the only quantifiable piece of information that comes from a BH eval.

Typically GAF of 50-54 will be a 50% rating and 55-59 will be a 30%.

The key for the OP to get his rating bumped up to 50% will to submit new evidence showing the frequency of panic attacks to occur more than once per week.

The OP can also try to present that he has a disturbance of motivation and/or mood to qualify for a 50% rating.

The GAF score matrix was developed to assist a BH professional to asses a patient in only three minutes time. Information can be left out, not addressed or incorrectly interpreted. If you look at the rating matrix in the VASRD the onlky quantifiable amount is the frequency of panic attacks. The OP should scour his medical records to find out if the questions have been asked and/or accuratly recorded.
 
I had a disability rating of 30% for panic disorder from 2007 after returning home from Iraq I put in a claim for PTSD in 2010. It has taken almost 3 years for them to make a decision and during that time my symptoms have me being boarded out of the military. They are offering me 40% permanent retirement. I am getting 10% for a neck injury (Shot in Face in Iraq). All the VA did for the PTSD is change the name of my Panic Disorder to PTSD with Panic Disorder, and then state this:
We reviewed the evidence received and determined your service-connected condition hasn't
increased in severity sufficiently to warrant a higher evaluation. The VA examiner related the
stressor to fear of hostile military or terrorist activity and that the VA examiner linked the PTSD
symptoms to the stressor. When more than one mental health condition has been diagnosed and
are service connected, the symptoms of each condition tend to overlap. Because of this, all
symptoms of each mental health condition are considered in one evaluation.

Hasn't increased! are they insane my whole life is miserable! I've been in and out of PTSD programs Doctors different meds trying to get a handle on this! They say if I ask for a reconsideration I risk loosing everything, so they are forcing me to play the lottery with what future I can still have.

Welcome to the PEB Forum! :)

In concurrence with ceilingfan, GAF score and VASRD doesn't directly equate for DoVA rating purposes. But, be aware that some DoVA raters will use the GAF score to yield a potential DoVA rating as based upon my current experiences within the DoD IDES MEB/PEB process.

In retrospect, the Global Assessment of Functioning (GAF) is a 100-point tool rating overall psychological, social and occupational functioning of people over 18 years of age and older. The GAF excludes physical and environment impairment. The GAF is included in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) in the section on multi-axial assessments. I understand that DSM-V was finally approved and released, but don't know if the DoVA has officially adopted it for VASRD use.

From my experiences within the DoD IDES MEB/PEB process to date, upon receipt of your IPEB findings beware of the DoVA D-RAS trying to underrate my PTSD rating due to the GAF score only. But, IAW 38 CFR Part 4.129, a minimum 50% evaluation is required with the establishment of a future examination for six months after separation for mental disorders due to traumatic stress.

Moreover, the application of the GAF score only in the determination of "reason for decision" by the DoVA PTSD rating is in direct violation of eCFR, Title 38, Part 4, Subpart B, 4.126(a). The Electronic Code of Federal Regulation states "The rating agency shall assign an evaluation based on all the evidence of record that bears on occupational and social impairment rather than solely on the examiner's assessment of the level of disability at the moment of the examination." ;)

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 
Hello, my concern is that I was rated for Panic Disorder and once I was diagnosed with PTSD they combined them together and left my rating at 30%. My condition has deteriorated after I completed a 12 week course to help with PTSD. I cannot explain why things for me became exponentially worse after that VA course. The wording from the VA rater saying that there was no significant change is disturbing to me. This was an initial claim and I have been sending them every bit of information they have requested for almost three years. The DOD is going off the VA's rating and are offering me a 30% permanent disability for this claim. If I ask for a second look from the VA I risk loosing retirement, it would be like gambling, I just don't understand why it has come down to that.
 
Hello, my concern is that I was rated for Panic Disorder and once I was diagnosed with PTSD they combined them together and left my rating at 30%. My condition has deteriorated after I completed a 12 week course to help with PTSD. I cannot explain why things for me became exponentially worse after that VA course. The wording from the VA rater saying that there was no significant change is disturbing to me. This was an initial claim and I have been sending them every bit of information they have requested for almost three years. The DOD is going off the VA's rating and are offering me a 30% permanent disability for this claim. If I ask for a second look from the VA I risk loosing retirement, it would be like gambling, I just don't understand why it has come down to that.
As warrior pointed out and what I was alluding to is that the PTSD, if unfitting, must be at minimum 50% at initial retirement via IDES.
 
I am presuming mimdalf is in the guard or reserve. As such, he is not protected by VASRD 4.129 which provides for an initial 50% rating as 4.129 requires symptoms to be severe enough to be removed from active military service which the VA is ruling means active duty. This is one of many issues I am trying to get the Recovering Warrior Task Force to address.

Mimdalf,

You are correct in that there is some risk that challenging the VA rating could impact your permanent DoD disability retirement decision. Once retired, you can go back to the VA and request an increase for your PTSD rating without risk to your DoD disability retirement. Once retired, be sure to apply for CRSC.

Mike
 
Will they ever change this law so I can receive Air Force pay concurrent with VA for those medically retired under 20 years? Seems wrong! I only have 9 years in.......but for them to medically retire me for a heart problems....seems so wrong.
 
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