broken

This web page is dedicated to the active duty and retired members of the Navy and Marine Corps who are or maybe suffering from PTSD. This web site puts all revelant information in one place. It is based on my experience and through trial and error. I enlisted in the Marine Corps in 1984. Then came the Naval Academy, West Point, Army Airborne and Navy SCUBA diver. I graduated TBS with honors and then went to Naval Flight Officers school. Following my winging, I selected F/A-18D's, did two deployments and became an Instructor at NSAWC. While there, I completed Top Gun(Adversary). I then did two combat tours in Afghanistan and Iraq. After the hostilities ended I went to the Naval Postgraduate School for a masters degree in software engineering and my third combat tour in Iraq. Following my return I showed symptoms of PTSD and was later discharged for PTSD.

I went through three phases during my time in the service and retirement. First is diagnosis. Then came the med board process and finally discharge.

I looked for information on the web concerning PTSD and even called one of the hot lines during the bad times. I spoke with a chaplin several times also to no avail. I finally called NAVY ONE SOURCE and obtained an appointment with a therapist and received my first diagnosis of PTSD. I did not go to the military medical system for fear of being kicked out. I called for a second opinion and got another appointment with a different therapist and walked away with my second diagnosis of PTSD. Following that appointment I resigned myself to seek help using the military medical system and prayed that I would be able to stay in the service. I went to medical and got a diagnosis of PTSD from a doctor and started the process of dealing with the military medical system. I received medication and therapy and subsequently a med board.

The med board process was lengthy. It took 5 months. You will be assigned a lawyer for this part. I went to Balboa for a formal diagnosis. This took 2 trips. The actual PEB consisted of two line officers and one medical officer. I also had 2 senior Marines with whom I served in combat show up as character witnesses. They served to show the stark contrast as to what my performances were before and after being diagnosed. The results of my Med board fell in favor to me and I elected not to appeal, but this isn't always the case.

My discharge came fairly fast. If possible, take your leave as terminal leave vice being paid for it. You will make more in the end. Also, check to see if you are eligible to take house hunting leave before separation. Go over your DD-214 thoroughly. It is difficult to change once signed. Make 2 copies of all of your records, especially the medical ones. The VA will need one and you will need one for reference and proof. At this point you are still not separated from service. The Navy has five years to affirm the findings, change them, or return you to active service. You will be required to report to a facility for re-evaluation on a yearly basis. I got the final decision after only one year. Again, the decision fell in my favor and I elected not to appeal.

Below is information that you will be evaluated against, or be used in your evaluation. Read it carefully, this will have lasting implications on your financial life for years to follow. Put a symptom to each of the criteria. It helps those evaluating you make that leap. You don't need to recall the GAF score, it is there so you can understand the numbers on your evals. One last thing, you will be receiving two separate ratings. One from the military service and an entirely separate one from the VA. If you elect to try for Social Security Disability Insurance, there will be another rating.

Shortcuts

DSM-IV Criteria for Posttraumatic Stress Disorder

Global Assesment of Functioning

Retirement vs Severance Pay

VA rating Exam Questions

Mississippi Scale for PTSD

VA re-rating exams

VA rating Criteria

PTSD and Alcohol/Drugs

Social Security Disability Application

CRSC and CRDP

VA Resources

TSGLI

Putting it all together

Motherhood (sage advice)

 

309.81    DSM-IV Criteria for Posttraumatic Stress Disorder

A. The person has been exposed to a traumatic event in which both of the following have been present: 

(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior.

B. The traumatic event is persistently re-experienced in one (or more) of the following ways: 

(1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.

(2) recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.

(3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.

(4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

(5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following: 

(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma 

(2) efforts to avoid activities, places, or people that arouse recollections of the trauma 

(3) inability to recall an important aspect of the trauma 

(4) markedly diminished interest or participation in significant activities 

(5) feeling of detachment or estrangement from others 

(6) restricted range of affect (e.g., unable to have loving feelings) 

(7) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following: 

(1) difficulty falling or staying asleep 
(2) irritability or outbursts of anger 
(3) difficulty concentrating 
(4) hyper vigilance 
(5) exaggerated startle response

E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.

F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify if
Acute: if duration of symptoms is less than 3 months 
Chronic: if duration of symptoms is 3 months or more

Specify if
With Delayed Onset: if onset of symptoms is at least 6 months after the stressor

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Global Assessment Functioning scale (GAF)

This is used in your ratings exams to determine your severity.


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, 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.
80 - 71 If symptoms are present they are transient and expectable reactions to psychosocial stressors; no more than slight impairment in social, occupational, or school functioning.
70 - 61 Some mild symptoms OR some difficulty in social, occupational, or school functioning, but generally functioning pretty well, has some meaningful interpersonal relationships.
60 - 51 Moderate symptoms OR moderate difficulty in social, occupational, or school functioning in social, occupational, or school functioning.
50 - 41 Serious symptoms OR any serious impairment in social, occupational, or school functioning.
40 - 31 Some impairment in reality testing or communication OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood.
30 - 21 Behavior is considerably influenced by delusions or hallucinations OR serious impairment in communication or judgment OR inability to function in almost all areas.
20 - 11 Some danger of hurting self or others OR occasionally fails to maintain minimal person hygiene OR gross impairment in communication.
10 - 01 Persistent danger of severely hurting self or others OR persistent inability to maintain minimal personal hygiene OR serious suicidal act with clear expectation of death.

GAF Score 1 - 30 This patient is a candidate for inpatient care
GAF Score 31 - 69 This patient is a candidate for outpatient care - either PHP, IOP or traditional outpatient counseling.
GAF Score 70 - > In most cases, medical necessity is not indicated because the patient is functioning too well to be a candidate for therapy

GAF score explained

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Retirement vs Severance Pay (SECNAVINST 1850.4D)

The severity of the injury determines whether a service member, who is eligible for benefits, receives disability retirement or disability severance pay. Service members rated with benefits, receives disability retirement or disability severance pay. Service members rated with a zero, 10, or 20 percent disability and less than 20 years of service will be separated from the service with disability severance pay. Disability severance pay is computed in the following manner:


Monthly Base Pay x 2 x Years of service (not to exceed 12 Years)


Service members with 20 or more years of active military service, or possessing a disability rated at 30 percent or more, receive disability retirement. Disability retirement is either permanent or temporary depending on whether the member’s disability is likely to change. Disability retirement pay is computed in the following manner for service members with less than 20 years of active duty military service:


30 percent-50 percent disability rating= 50 percent of basic pay;
50 percent-70 percent disability rating= that percentage of basic pay;
80 percent-100 percent disability rating= 75 percent of basic pay.

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VA rating Exam Questions

These are the questions that the examiner will ask you on your first evaluation. Read the questions carefully. It is best if you can express an experience for each of the symptoms. This is not to say that you have one for each symptom.

Initial Evaluation for Post-Traumatic Stress Disorder

Name:

SSN:

Date of Exam:

C-number:

Place of Exam:



The following health care providers can perform initial examinations for PTSD.
a board-certified or board "eligible" psychiatrist;
a licensed doctorate-level psychologist;
a doctorate-level mental health provider under the close supervision of a board-certified or board eligible psychiatrist or licensed doctorate-level psychologist
a psychiatry resident under close supervision of a board certified or board eligible psychiatrist or licensed doctorate-level psychologist; or
a clinical or counseling psychologist completing a one-year internship or residency (for purposes of a doctorate-level degree) under close supervision of a board-certified or board eligible psychiatrist or licensed doctorate-level psychologist.



A. Identifying Information:

B. Sources of Information:

C. Review of Medical Records:

  1. Past Medical History:
  1. Previous hospitalizations and outpatient care.
  2. Complete medical history is required, including history since discharge from military service.
  3. Review of Claims Folder is required on initial exams to establish or rule out the diagnosis.
  1. Present Medical History - over the past one year.
  1. Frequency, severity and duration of medical and psychiatric symptoms.
  2. Length of remissions, to include capacity for adjustment during periods of remissions.

D. Examination (Objective Findings):
Address each of the following and fully describe:
History (Subjective Complaints):
Comment on:
Premilitary History (refer to social-industrial survey if completed)

Military History

NOTE: Service connection for post-traumatic stress disorder (PTSD) requires medical evidence establishing a diagnosis of the condition that conforms to the diagnostic criteria of DSM-IV, credible supporting evidence that the claimed in-service stressor actually occurred, and a link, established by medical evidence, between current symptomatology and the claimed in-service stressor. It is the responsibility of the examiner to indicate the traumatic stressor leading to PTSD, if he or she makes the diagnosis of PTSD.

A diagnosis of PTSD cannot be adequately documented or ruled out without obtaining a detailed military history and reviewing the claims folder. This means that initial review of the folder prior to examination, the history and examination itself, and the dictation for an examination initially establishing PTSD will often require more time than for examinations of other disorders. Ninety minutes to two hours on an initial exam is normal.
Post-Military Trauma History (refer to social-industrial survey if completed)

Post-Military Psychosocial Adjustment (refer to social-industrial survey if completed)

E. Mental Status Examination
Conduct a mental status examination aimed at screening for DSM-IV mental disorders. Describe and fully explain the existence, frequency and extent of the following signs and symptoms, or any others present, and relate how they interfere with employment and social functioning:

F. Assessment of PTSD

G. Psychometric Testing Results

H. Diagnosis:

  1. The Diagnosis must conform to DSM-IV and be supported by the findings on the examination report.
  2. If there are multiple mental disorders, discuss their relationship with PTSD.
  3. The evaluation is based on the effects of the signs and symptoms on occupational and social functioning.

NOTE: VA is prohibited by statute, 38 U.S.C. 1110, from paying compensation for a disability that is a result of the veteran's own ALCOHOL OR DRUG ABUSE. However, when a veteran's alcohol or drug abuse disability is secondary to or is caused or aggravated by a primary service-connected disorder, the veteran may be entitled to compensation. See Allen v. Principi, 237 F.3d 1368, 1381 (Fed. Cir. 2001) Therefore, it is important to determine the relationship, if any, between a service-connected disorder and a disability resulting from the veteran's alcohol or drug abuse. Unless alcohol or drug abuse is secondary to or is caused or aggravated by another mental disorder, you should separate, to the extent possible, the effects of the alcohol or drug abuse from the effects of the other mental disorder(s). If it is not possible to separate the effects in such cases, please explain why.
I. Diagnostic Status

J. Global Assessment of Functioning (GAF):
NOTE: The complete multi-axial format as specified by DSM-IV may be required by BVA REMAND or specifically requested by the rating specialist. If so, include the GAF score and note whether it refers to current functioning. A BVA REMAND may also request, in addition to an overall GAF score, that a separate GAF score be provided for each mental disorder present when there are multiple Axis I or Axis II diagnoses and not all are service- connected. If separate GAF scores can be given, an explanation and discussion of the rationale is needed. If it is not possible, an explanation as to why not is needed. (See the above note pertaining to alcohol or drug abuse.)

DSM-IV is only for application from 11/7/96 on. Therefore, when applicable note whether the diagnosis of PTSD was supportable under DSM-III-R prior to that date. The prior criteria under DSM-III-R are provided as an attachment.
K. Capacity to Manage Financial Affairs: Mental competency, for VA benefits purposes, refers only to the ability of the veteran to manage VA benefit payments in his or her own best interest, and not to any other subject. Mental incompetency, for VA benefits purposes, means that the veteran, because of injury or disease, is not capable of managing benefit payments in his or her best interest. In order to assist raters in making a legal determination as to competency, please address the following:
What is the impact of injury or disease on the veteran's ability to manage his or her financial affairs, including consideration of such things as knowing the amount of his or her VA benefit payment, knowing the amounts and types of bills owed monthly, and handling the payment prudently? Does the veteran handle the money and pay the bills himself or herself?

Based on your examination, do you believe that the veteran is capable of managing his or her financial affairs? Please provide examples to support your conclusion.

If you believe a Social Work Service assessment is needed before you can give your opinion on the veteran's ability to manage his or her financial affairs, please explain why.


L. Other Opinion: Furnish any other specific opinion requested by the rating board or BVA remand (furnish the complete rationale and citation of medical texts or treatise supporting opinion, if medical literature review was undertaken). If the requested opinion is medically not ascertainable on exam or testing please state why. If the requested opinion can not be expressed without resorting to speculation or making improbable assumptions say so, and explain why. If the opinion asks " ... is it at least as likely as not ... ", fully explain the clinical findings and rationale for the opinion.

M. Integrated Summary and Conclusions


N. Effects of PTSD on Occupational and Social Functioning
Evaluation of PTSD is based on its effects on occupational and social functioning. Select the appropriate assessment of the veteran from the choices below:

OR

OR

OR

OR

OR

OR

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Mississippi Scale for PTSD

This is the preliminary eval you take prior to the actual interview. A score above 107 is indicative of PTSD.

Questionnaire

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VA re-rating exams

Re-rating exams are conducted every three years or so.

It entails recounting the previous 18 months of your life. Questions asked were concerning hospitalizations, frequency of visits and the such. Other questions asked were of orientation as to the day, month and year, and simple memory tests for short and long term memory function. My Dr. did not peel my head back and ask me to recount the events leading to PTSD. The interview took about an hour and his write up was done by the next day for me to read via my social worker. Key terms to look for are total occupational and social dysfunction.

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VA rating Criteria

38 C.F.R. § 4.130, DC 9411
General Rating Formula for Mental Disorders:

Total occupational and social impairment, due to such symptoms as: gross impairment in thought process 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 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%

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PTSD and Alcohol/Drugs

PTSD and alcohol/drugs are a lethal mix. Most of the successfully recovering veterans that I know of have stopped drinking/useing for long term sobriety. You will be quizzed on your alcohol/drug use during all of your ratings exams. They are trying to determine if the alcohol/drug abuse came before the PTSD. If it did then your ratings for PTSD will suffer. Many verterns suffering from PTSD turn to alcohol and drugs for relief. It is your best interest to only use the medications prescribed to you. Alcohol and drug use confuses the issue. During my diagnosis I had about 13 years of sobiety and it wasn't a factor. I turned to alcohol about a year after being diagnosed. It didn't work. The meds stopped working and the symptoms became worse. Once I stopped again the meds started working. I have been sober for about a year now.

Here is the note from the PTSD exam: VA is prohibited by statute, 38 U.S.C. 1110, from paying compensation for a disability that is a result of the veteran's own ALCOHOL OR DRUG ABUSE. However, when a veteran's alcohol or drug abuse disability is secondary to or is caused or aggravated by a primary service-connected disorder, the veteran may be entitled to compensation. See Allen v. Principi, 237 F.3d 1368, 1381 (Fed. Cir. 2001). Therefore, it is important to determine the relationship, if any, between a service-connected disorder and a disability resulting from the veteran's alcohol or drug abuse. Unless alcohol or drug abuse is secondary to or is caused or aggravated by another mental disorder, you should separate, to the extent possible, the effects of the alcohol or drug abuse from the effects of the other mental disorder(s). Here is a good article to read on the subject.

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Social Security Disability Application

Here is the determining factors for Social Security. It is vitally important to have all of your paperwork for the evals and hospitalizations with you at the time of your interview. If you are denied the first time, your package automatically gets resubmitted and evaluated by a different set of social workers.

§507 You are considered "disabled" and entitled to disabled worker's benefits if you meet the following conditions:

  1. You are unable to engage in any substantial gainful activity (see §603) because of a physical or mental impairment (see §601). You must not only be unable to do your previous work, but also any other type of work considering your age, education, and work experience (see §609);

    Note: It does not matter whether such work exists in your immediate area, whether a specific job vacancy exists, or whether you would be hired if you applied for work.

  2. Your impairment(s) must be established by objective medical evidence;

  3. It is expected that your impairment(s) will either result in death or last for at least 12 months in a row; and

  4. You must meet the non-medical criteria needed to be insured by the program.

§203 You are fully insured if:

  1. You have at least one credit for each calendar year after 1950; or

  2. If you turn 21 after 1950, you have at least one credit for each calendar year after you turned 21 and the earliest of the following:

    1. The year before you turn 62;

    2. The year before you die; or

    3. The year before you become disabled.

SSDI application

Use this link to apply for SSDI. I followed the text to the letter and received my SSDI in about three months. This is much faster than the national average and I am not sure why I got mine so fast and on the first attempt. This rating is either yes or no. The SSA does not rate in degrees of severity as is done by the military or the VA. You can appeal your decision and hire lawyers for this if you think you need to. If you have all of your paperwork in order and attend the exam with it things should go your way. I had copies of all of my hospitalizations and diagnosis with me for the examiner. This seemed to help.

Here is a link to the SSA Handbook

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CRSC and CRDP

Combat Related Special Compensation (CRSC) is non-taxable and non divisible entitlement that you have to apply for through the VA for those above 10%, whose disability is from combat, and are receiving retired pay. The process is about three months. CRSC application This is a new application from the one I used and would advise you seek counsel before filling it out and submitting it. This is a life-long entitlement and once accepted can't be stopped. CRSC calculation

Concurrent Retirement and Disability Pay (CRDP) is taxable and only payable to those having a disability of 50% or greater and have more than 20 years of service. You are automatically evaluated for this and no action is required. If you fit the criteria, payments will automatically follow. If you aren't receiving this entitlement contact a VA social worker.

These two payments are mutually exclusive, you can't receive both. If you are eligible for both you can choose which one you want to receive. Open season begins in December.

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TSGLI

Traumatic Servicemembers Group Life Insurance is a coverage for those suffering from a traumatic injury such as a loss of limb or eyesight or traumatic brain injury (TBI). Currently I cannot find any source to say that it is payable to those suffering from PTSD although there has been debate on it. If it is inacted the payment would be tax free and probably be around $25,000. TSGLI

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VA Resources

VA PTSD Programs This is a comprehensive list of all the national VA PTSD programs. You can discuss with your provider which ones are best suited for you and make arrangements to attend one. I attended one out of state and the VA reimbursed me my travel costs. I found the treatment to be helpful in identifing my symptoms and tools to help me manage my PTSD.

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Putting it all together

Putting the money all together. First take your military retirement. Your take home is your base pay times your scheduled service disability rating. Next is the VA amount. Obtain this by looking up your VA amount off of the VA pay charts. Subtract the VA amount from your take home pay, and is called "VA offset". What is left is what you will be taxed on. You will get a check every month based on this amount. If you apply for CRSC it will be roughly the same as the disability pay minus the VA Offset. SSDI is based on what you put into the Social Security program over the years. Children are eligible for additional compensation and average about half of your SSDI. SSDI is taxable once your earnings reach a certain limit and you must be totally unemployable by the SSA to receive it. Finally there is State unemployment. I don't have any experience with this as each state is different. Look into this as soon as you can as the benefits generally run out within a year.

With numbers:

An E-5 with a wife and one child, over six years makes a base pay of $2,499.00. If he is awarded a 50% rating from the service, the take home pay is $1,248.50. The VA gives the E-5 a 50% disability rating, from the VA charts he will receive $899. This is the VA offset. Subtract the two. $1248.50 - $899 = $349. This is the additional money the service will send you every month. The amount of $349 is taxable, the $899 is not. Add CRSC (it is roughly equal to the disability pay minus the VA offset), $360. Now SSDI. For example, say the E-5 is rated as totally unemployable by Social Security. The E-5 is eligible for SSDI and assistance for the one child. Let's guesstimate again, say $400.00 and $223.00 for the child.

Let's total it up:

$899 + $349 + $360 + $400 + $223 = $2231

If the E-5 decides that this isn't enough to live on and decides to get a job he loses the SSDI making the total income $1608. If at the next ratings exam they reduce the percentage of disability to 30%, the offset will change but the money the E-5 gets from the service and the VA will always total $1248.50.

If the E-5 doesn't receive retirement pay because he only got 20% then the pay works out differently. Let's say he received 20% from the service. He will get a check for $30,000 as a one-time payment. The VA rates him at 30% to start. From the chart he will receive $453. He is not eligble for CRSC. I have heard of people getting SSDI with a rating as low as 30%, but in this case he is denied. His total monthly income will be $453.

Lastly if the E-5 doesn't get rated during mustering out he loses the $30,000 and only gets $453 for the rest of his life.

As you can see, this is pretty serious stuff and there is a big difference in pay amounts if the PTSD is caught/diagnosed while in service or not. They are not allowed to break you and not pay for it. If you are broken, get help as soon as possible. Fakers and malingerers will be sorted out quickly with the tests they administer to you. If you are in the service and think you have PTSD it is a big step to come forward and ask for help. Think about it long and hard.

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Motherhood (sage advice)

This section is based on my experience working within the system and watching others. First off there are entities out there that are ready to help. One of those is the DAV - Disabled American Veterans. That group will help you whether you are a memeber or not and will do just about anything to help you with your case. You will also be assigned a VA caseworker. These people are swamped with cases and handle them based on which one is next in line or closest to the C&P exam. I paid the $250 for a lifetime membership for the DAV and found it well worth it.

Exams - Here is the only place you get to actually talk to an examiner. Make your answers brief but don't make them yes/no. Explain yourself in a short three to five sentence paragraph. Know the definition of PTSD thoroughly. Be able to put an experience against each of the criteria if you can. This will help your examiner fit you into a PTSD mold. Know the rating scale before you get to the examination. See how you fit against that scale. Are you looking to move up in rating? Read and reread the scale criteria and apply your PTSD criteria against it. If in the past you have reported subsiding effects and your counselor has written them down, expect that to be used against you in your ratings board. This goes without saying, but ensure your paperwork is filled out completely and accurately and show up for your appointments. It will be just like a non-submission if you don't.

Taxes - I touched briefly on it above, but taxes are a good way to get in trouble quickly. Have a professional do them for the first couple of years. It is worth it. SSDI is taxable once your income reaches certain levels. Here is a place to start. Taxable benefits

Benefits - You are authorized full benefits for five years after you are discharged. Then, depending on your severity, you get certain benefits. For example, at 100% you get full dental benefits. Medical benefits Medical priority groups

You have the right to see your medical records at any time. A good thought is to get a copy of your records and browse through them looking for those positive comments. Figure out how to minimumize them against your PTSD criteria.

Don't be afraid of going to or being admitted to a hospital. If you are that bad that someone is willing to admit you, by all means go. You are not in a position to minimize your severity. PTSD is followed by Chronic Depression. They have meds that are good for both. I take mine.

Stepping out - This is an extremely difficult question to answer. Asking for help for someone with no intention of staying for a career is totally different than someone who has career asperations. As discussed above the pay differences are huge, but the stygma is just as big. It is possible to stay in the service with PTSD. It is based on your severity.

A note to the leadership - PTSD manifests in many different forms. If your outstanding sailor or Marine starts acting out it may not only be time for a page 11, but a trip to psych. The earlier PTSD is caught, the sooner it can be dealt with and save years of agony. You may even save a life. The longer PTSD remains untreated, the harder it is to treat.

Not a lot in this section is positive. In the end it is a numbers game for the VA. They are there to dispense medication and therapy to get you better. Then they use that against you in working out your pay.

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PTSD Blog For other questions and answers.

 

Email Rob


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