Search Jims Mailbag

PTSD and long-term disability

listen this page Listen the this Page
Posted on: Wednesday, January 23, 2013
Printer-friendly versionPrinter-friendly version

Hello Jim,

I have a IU C&P hearing on 1-16-13, I have a 70% disibility for PTSD, from Vietnam Service. My last C&P was Aug 2012, what can I expect for my C&P, I'm awaiting my SS disability which I filed in Oct. 2012. I've been seeing the VA Doc's for PTSD since July 2011, and shrink from Oct. 2 bi-weekly which it is on going, she also wants me to be a part of a New Study in AZ via TV which will last 8 weeks once that starts, which has 5 Doc's, but is waiting for me to be ready for that treatment, they have put me on Mirtazapine for deprssion and sleep. What should I beaware of in this C&P for IU?

Reply:

It's very difficult to predict exactly what VA is looking for. The diagnosis and description of any mental health condition can be elusive. Mental health injuries aren't like a broken bone. An observer can easily see the broken bone on an x-ray and determine how bad the break is and how well it is healing over time. That's just not true with a mental health problem.

If your PTSD has been established, VA will probably be trying to determine how likely it is that you will improve in the future with treatment. VA always sees improvement in any disabling condition as the ultimate goal. This is particularly true of mental health conditions because most professionals agree that treatment can make great improvements.

Most of us would rather be "cured" to a point where we can work and function in society. VA is loathe to label a younger veteran as permanently and totally disabled with a mental health condition if there is any reasonable chance of improvement. In VA language, "younger" vets are those under the age of 55 or so.

Once the age of 55 is reached, it's much more likely that VA will award a more lasting (P & T) benefit. In broad terms, society agrees that as people age, they become less likely to be able to learn new skills and to hold gainful employment. If you're younger than that, VA would much rather rehabilitate you.

The exam shouldn't cause you a lot of concern. It sounds like you're an intelligent guy who has a good understanding of your condition and the options you have for treatment. You should go into it prepared to tell the examiner just how your condition affects your daily life.

A good C & P exam, whether for physical or mental health reasons, should include how the disabling condition affects our activities of daily living (ADLs). For example...can you do the basics of grooming alone and unaided? Does someone need to remind you to take care of your appearance like showering regularly and combing your hair, shaving and performing oral hygiene? Do you prepare your own meals that are healthy or are you hooked on pizza delivery for a lot of meals? Do you maintain your living environment in a manner that shows that you're concerned about cleanliness and order surrounding you? Are you able to go shopping in a crowded store during the day or do you wait for the cover of darkness?

In my mind, the routine and ordinary ADLs are a most important issue that sometimes aren't addressed as well as they should be. To say that "I'm depressed" doesn't always reflect just how that affects your life. This is an opportunity for you to voice for the record how profoundly your PTSD restricts you from living your life to the fullest.

You may want to make a written record of what you can and can't do considering your PTSD symptoms. List the things that make you uncomfortable (grocery shopping) and the things that you simply can't do (going to a darkened movie theater) as well as the things that frighten you.

I was recently speaking with a young veteran about his future as a truck driver. That is an industry that is booming and there are a lot of openings for young vets. I learned from him that he was afraid to drive his car and his spouse did most of the driving. I had assumed he was fearful of objects that may look like an IED or something similar. He corrected me. He couldn't drive because he didn't have his weapon locked, loaded and strung across his chest within easy reach to shoot any vehicle that got too close. He had never experienced an IED but he had suffered attacks on a number of occasions by civilian vehicles. To be without his weapons instilled a deep panic any time he was in a moving vehicle. He won't ever be a truck driver.

Taking written notes with you to an exam is always a good way to keep the exam on a proper course. Most of us get anxious and an hour after the exam we remember all the things we should have said. Keep your notes to yourself brief (no more than a single page) and orderly, take a copy for the examiner and you'll do fine.
 

Complete Mailbag