Here is some of the text from my VARR. I included only the mental health portion as it applies widely to a variety of people here on this forum. I left out the Myasthenia Gravis part as there are only like 3 of us on this board. hope this helps someone. I was able to go from 50% to 70% for MH with this VARR, so it is a good example of one that worked.
MEMORANDUM THRU President, U.S. Army Physical Evaluation Board...........
FOR U.S. Department of Veterans Affairs.......
SUBJECT: Request for Reconsideration of VA Rating Decision in the Matter of CPT
___________ (xxxx)
1. Requested Relief: CPT ___ respectfully requests a reconsideration of his
Disability Evaluation System Proposed Rating (Proposed Rating). Specifically, CPT
____ requests (1) an increase to a 70 percent rating for his Generalized Anxiety
and Depressive Disorder rated under VA Schedule for Rating Disabilities (VASRD)
Diagnostic Code (DC) 9434.
2. Generalized Anxiety and Depressive Disorder:
a. Rule (DC 9434): According to the General Rating Formula for Mental Disorders,
a 70 percent rating is warranted when 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 work like
setting) inability to establish and maintain effective relationships.
b. Evidence:
(1) On 4 February 2015, _____________ conducted a Mental
Health Evaluation and completed the Mental Disorder (Other than PTSD and Eating
Disorders) DBQ on CPT ___________. See Exhibit 1. On September 2015, _______ also completed a DBQ
for CPT _________. See Exhibit 2. Both mental health providers from ___________ Psychiatric noted a GAF
score of 50 with
occupational and social impairment with deficiencies in most areas, such as work,
school, family relations, judgment, thinking, or mood. Significantly, his symptoms
include suicidal ideation. Some of the other symptoms noted on the DBQ and letter
include: Near-continuous panic or depression affecting the ability to function
independently, appropriately and effectively, Difficulty in adapting to stressful
circumstances (including work or a work-like setting) and Inability to establish and
maintain effective relationships. Furthermore, CPT _____ most recent PHA mental
health screening (AUG2015) states that he has extremely high anxiety levels and
suicidal ideations currently. See Exhibit 3.
(2) CPT ________ has been receiving treatment from Dr _______ since
July 2014. CPT _________ is on a very restrictive profile for his Anxiety and Depressive
Disorder. See Exhibit 4. In the current Commander’s functional Statement 7652, LTC ________
notes CPT ______ anxiety and depression cause him to have an inability to
establish and maintain effective work relationships with other staff and
perform duties due to depression and anxiety. His commander's functional statement also states
that he “displays difficulty working under pressure and completing tasks in a timely
manner, his anxiety has a negative impact on the workplace further reducing his
effectiveness as the leader of a team”. When his anxiety levels are high, he locks
himself in his office and does not interact with anyone. See Exhibit 5. His wife and
several co-workers attest to the severity of his anxiety and depression. See Exhibit 7
(______ Statement), Exhibit 9 (___________ Statement), Exhibit 11
(______ Statement) and Exhibit 10 (spouse). Please see also the
statement provided by ___________ as Exhibit 9.
(3) Dr. _________ noted CPT _____ exhibits deficiencies in the areas of
work, family relations, thinking, and mood and is expressed by a near continuous
depressive state that prevents the patient from functioning appropriately and effectively
in those areas. See Exhibit 1. Dr __________ states in her recent memorandum
that he has difficulty adapting to stressful work settings, locking himself in his office and
leaving early daily to avoid others due to a feeling of continuous panic that was not
resolved with medication. She also describes his inability to maintain relationships citing
his termination of the relationship with both his mother and a best friend.
His wife also states that he emotionally shuts out her and their two children. See Exhibit
9. See also CPT _____ statement Exhibit 10.
(4) CPT _______ has expressed suicidal ideations and/or intent on at least 6
different occasions to six different mental health professionals and his spouse. Please
see PA _____, 2015 PHA, deployment mental health assessment portion
(Exhibit 3); ________________ Psychiatric MH
provider AUG 2015 DBQ (Exhibit 2); __________________,
Psychiatric care MH provider for over a year, documented in FEB 2014 DBQ (Exhibit 1);
VA Psychologist ______, Jan 2015, VA CP MH DBQ (Exhibit 12); CP examiner_______
Brief Suicide risk assessment Jan 2015, CP exam (Exhibit 13), and; Jan 2015
MEB Narsum Psychiatric addendum, _______ LCSW and MAJ __________
Psychatrist (Exhibit 14). Finally, the Physical Evaluation Board determined found his
behavioral health disorder to be of such severity as to render unfit for continued military
service. See Exhibit 15.
c. Analysis: Based upon the medical records and statements by his medical
providers, Commander, peers, family and his own, CPT _____ exhibits occupational
and social impairments with deficiencies in most areas. Based upon his level of
impairment, CPT _____ respectfully asserts his Generalized Anxiety Disorder and
Depressive Disorder should be rated at a 70 percent rating.
MEMORANDUM THRU President, U.S. Army Physical Evaluation Board...........
FOR U.S. Department of Veterans Affairs.......
SUBJECT: Request for Reconsideration of VA Rating Decision in the Matter of CPT
___________ (xxxx)
1. Requested Relief: CPT ___ respectfully requests a reconsideration of his
Disability Evaluation System Proposed Rating (Proposed Rating). Specifically, CPT
____ requests (1) an increase to a 70 percent rating for his Generalized Anxiety
and Depressive Disorder rated under VA Schedule for Rating Disabilities (VASRD)
Diagnostic Code (DC) 9434.
2. Generalized Anxiety and Depressive Disorder:
a. Rule (DC 9434): According to the General Rating Formula for Mental Disorders,
a 70 percent rating is warranted when 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 work like
setting) inability to establish and maintain effective relationships.
b. Evidence:
(1) On 4 February 2015, _____________ conducted a Mental
Health Evaluation and completed the Mental Disorder (Other than PTSD and Eating
Disorders) DBQ on CPT ___________. See Exhibit 1. On September 2015, _______ also completed a DBQ
for CPT _________. See Exhibit 2. Both mental health providers from ___________ Psychiatric noted a GAF
score of 50 with
occupational and social impairment with deficiencies in most areas, such as work,
school, family relations, judgment, thinking, or mood. Significantly, his symptoms
include suicidal ideation. Some of the other symptoms noted on the DBQ and letter
include: Near-continuous panic or depression affecting the ability to function
independently, appropriately and effectively, Difficulty in adapting to stressful
circumstances (including work or a work-like setting) and Inability to establish and
maintain effective relationships. Furthermore, CPT _____ most recent PHA mental
health screening (AUG2015) states that he has extremely high anxiety levels and
suicidal ideations currently. See Exhibit 3.
(2) CPT ________ has been receiving treatment from Dr _______ since
July 2014. CPT _________ is on a very restrictive profile for his Anxiety and Depressive
Disorder. See Exhibit 4. In the current Commander’s functional Statement 7652, LTC ________
notes CPT ______ anxiety and depression cause him to have an inability to
establish and maintain effective work relationships with other staff and
perform duties due to depression and anxiety. His commander's functional statement also states
that he “displays difficulty working under pressure and completing tasks in a timely
manner, his anxiety has a negative impact on the workplace further reducing his
effectiveness as the leader of a team”. When his anxiety levels are high, he locks
himself in his office and does not interact with anyone. See Exhibit 5. His wife and
several co-workers attest to the severity of his anxiety and depression. See Exhibit 7
(______ Statement), Exhibit 9 (___________ Statement), Exhibit 11
(______ Statement) and Exhibit 10 (spouse). Please see also the
statement provided by ___________ as Exhibit 9.
(3) Dr. _________ noted CPT _____ exhibits deficiencies in the areas of
work, family relations, thinking, and mood and is expressed by a near continuous
depressive state that prevents the patient from functioning appropriately and effectively
in those areas. See Exhibit 1. Dr __________ states in her recent memorandum
that he has difficulty adapting to stressful work settings, locking himself in his office and
leaving early daily to avoid others due to a feeling of continuous panic that was not
resolved with medication. She also describes his inability to maintain relationships citing
his termination of the relationship with both his mother and a best friend.
His wife also states that he emotionally shuts out her and their two children. See Exhibit
9. See also CPT _____ statement Exhibit 10.
(4) CPT _______ has expressed suicidal ideations and/or intent on at least 6
different occasions to six different mental health professionals and his spouse. Please
see PA _____, 2015 PHA, deployment mental health assessment portion
(Exhibit 3); ________________ Psychiatric MH
provider AUG 2015 DBQ (Exhibit 2); __________________,
Psychiatric care MH provider for over a year, documented in FEB 2014 DBQ (Exhibit 1);
VA Psychologist ______, Jan 2015, VA CP MH DBQ (Exhibit 12); CP examiner_______
Brief Suicide risk assessment Jan 2015, CP exam (Exhibit 13), and; Jan 2015
MEB Narsum Psychiatric addendum, _______ LCSW and MAJ __________
Psychatrist (Exhibit 14). Finally, the Physical Evaluation Board determined found his
behavioral health disorder to be of such severity as to render unfit for continued military
service. See Exhibit 15.
c. Analysis: Based upon the medical records and statements by his medical
providers, Commander, peers, family and his own, CPT _____ exhibits occupational
and social impairments with deficiencies in most areas. Based upon his level of
impairment, CPT _____ respectfully asserts his Generalized Anxiety Disorder and
Depressive Disorder should be rated at a 70 percent rating.