Reducing Compensation For PTSD: Can It Happen?



 

You’ve been fighting a long time with symptoms of PTSD, and after the VA grants your claim, you are told that your compensation may be cut in the near future due to a temporary improvement or even just an improvement.

I tell veterans not to worry about this. PTSD is a lot different than a physical disability. Certain physical conditions do show improvement, and the rating percentage can be reduced at some point. But with PTSD, any long term improvement is not likely to happen (at least improvement that would deserve a rating cut).

When you are first service-connected for PTSD, you may be called in for the first couple of years for a Comp Exam, but this doesn’t mean you are going to lose your percentage.

The VA is so swamped with claims right now from the Middle East Wars that an easily settled PTSD claim is not going to be called back in any time in the near future. That would just add another claim to the already full docket.

Also, the VA cannot cut a veteran with PTSD for any short term improvement without considering the entire claim history.

One veteran who is currently 100% for Individual Unemployability was told that he would be called in for a future exam because ‘improvement was anticipated with continued therapy’.

 

Just because a veteran improves on a temporary basis (there is no permanent long-term improvement of PTSD) does not mean the veteran is all of a sudden capable of holding a permanent full time job, or spending months or years in some Voc Rehab training program. Still, it would be best for the veteran to continue therapy, or start therapy again until the condition is made permanent.

The VA must follow regulations in the CFR (Code of Federal Regulations) before reducing the percentages of any disabled veteran.

Veterans who have held a rating for less than five years are protected under several rules. According to the CFR, the VA must find that there has been an improvement in the level of disability before reducing the percentage rating. The entire history of the disability must be reviewed. The evidence must show that there has been some positive improvement in the veteran’s ability to live and work. (Improvement does not mean such silly things as your ability to walk your dog down a public street or playing cards once a year...such excuses have been used to cut veterans by saying their social interaction skills have improved).

Any attempt at reduction must also include a current Compensation Exam covering the issue of the disability. A Comp Exam for PTSD which does not include the issues bothering the veteran is not valid.

Veterans with PTSD can expect to keep their percentage without fear of reduction.

The GAF Scale

Camp Books North of Danang during TET 1968
2 KIA at this location from a 122 rocket

THE GAF SCALE

(I get so many questions about the GAF scale, I have to include it every so often to make everyone aware of it. They use it to determine your daily level of PTSD.)

91-100 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.
 
81-90 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)
 
71-80 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).
 
61-70 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.
 
51-60 Moderate symptoms (e.g., flat affect and circumstantial speech, occasional panic attacks) or moderate difficulty in social, occupational, or school functioning (few friends, conflicts with peers or co-workers).
 
41-50 Severe symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting) or any serious impairment in social, occupational or school functioning (no friends, unable to keep a job for any length of time ).
 
31-40 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 (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).

21-30 Behavior is considerably influenced by delusions or hallucinations or serious impairment in judgment (sometimes incoherent, acts inappropriately, suicidal preoccupation) or inability to function in all areas (stays in bed all day, no job, home).
 
11-20 Some danger of hurting self or others (suicidal attempts without clear expectation of death; frequently violent; manic excitement) or occasionally fails to maintain minimal personal hygiene (smears feces) or gross impairment in communication (e.g., largely incoherent or mute).
 
1-10 Persistent danger of severely hurting self or others or persistent inability to maintain minimal personal hygiene or serious suicidal acts which would result in death to veteran or others.
 

  Most combat veterans with PTSD are probably between 50 and 30 on the GAF Scale. Anything below 45 should be a 50 to 70 percent rating, with possibility for unemployability. Anything below 40 should be a definite case for unemployability status.
   But just because your GAF is rated higher on any given visit is not a valid reason for the VA to cut your percentage without taking the entire claim history into consideration. Some days you may feel better than other days, and this is no grounds for a reduction.

Dennis Latham's PTSD thriller MICHAEL IN HELL

The Joy Of Shingles (There Is None.)

My face three months after benign bump removed from my jaw.
The long recovery hit my immune system hard.


Shingles Are A Living Hell

  It’s been a bad year for me, or I should say the left side of my face and head. In April, I had the operation to remove a benign bump on the left side of my face, but they had to peel my face back to do it so the nerves wouldn’t be damaged. Then, my face swelled up for three months.

  In August, I began to feel better and my face had pretty much returned to normal. On August 30, I had a headache that wouldn’t go away on the left side of my head and felt like I had a sty forming on my left eye or like I had something under the lid. (I never get headaches and I’ve never had a sty come out .)

  Two days later, my left eyeball was bright red, my left forehead and scalp burned like a real bad sunburn when I touched it, and I had clusters of blisters on my left forehead and all through the left side of my scalp. I got some Murine, but that didn’t help my eye and burned like hell.

  I could have gone to the VA emergency in Cincinnati, but I was afraid they wouldn’t be serious in helping me or they would try to refer me to a clinic days later. I didn’t think my eye could wait that long. My wife called our family doctor and I went the next morning.

  People had only two reactions when they saw my eye: Holy Crap or I’ll pray for you.

  The doctor gave me a steroid shot and antibiotics for seven days three times a day at 8.00 a pill. I also got some eye drops, Tobramycin, in a bottle the size of my thumb for 102.00. Our doctor walked me downstairs to the eye doctor on the first floor and told them I should be seen right away.

  A few hours later, the eye doctor told me I had ulcers on the cornea, but he thought I had gotten there soon enough and the drops and antibiotics would heal them without eye damage. (The eye is the worst place to get shingles because it can lead to severe vision loss and blurring if not treated right away.)

  By the next morning, the blisters had moved down the left side of my nose. I gave thanks that I didn’t have them between my legs, but I was real miserable and afraid I would lose vision in my left eye.

  The drops and shot and anti-biotics started to work miracles in a few days. The bright red eye returned to normal in a few days, but my eye swelled and turned purple and my vision is still not 100% because I still have a die-hard lesion on the tip of my eyelid.

  Within a week, scabs formed, most of which were in my scalp and on my forehead. The burning was slowly replaced by a stinging itch and the feel of things like spiders crawling in my scalp and down my forehead. Shingles also sucks all the energy out of you. I didn’t feel like doing anything and didn’t have much interest in anything.

  Me and my wife sing big band music. We had a gig about seven days into my Shingle attack while they were full blown. I took Hydrocodone for pain. She did a great makeup job on my face, and I wore sunglasses to conceal my left eye, which now looked like I had been punched. I wore my Frank Sinatra hat. I made it through the gig without a problem.

  The non-stop dull headache went away after a few weeks. By week four, all the lesions were gone except for the one on the tip of my eyelid. I still had the tormenting crawling sensation on my forehead and scalp. I went back to the eye doctor. He told me the eye was healed without damage but my vision would be slightly off as long as the eyelid was still involved. He also said that Shingles on the head and scalp was some of the most difficult to get rid of and could linger for a long time no matter what medicine a person takes. I didn’t like hearing that.

  As I write this, I’m into week five. The constant crawling itch is still with me, and my left eyelid still has an active redness, slight swelling, and is sore. I wouldn’t wish this stuff on my worst enemy. The scalp wasn’t all that bad unless I touched it or washed my hair. Once it started healing and the itching began, then it got bad. The burning is pretty much gone except for one segment of my forehead.

  Shingles is caused by the same virus that causes chickenpox. If you had chickenpox, you have the virus in you, looking for a chance to come back out. It is not contagious, but people often think it is, like they do poison oak or ivy since the blisters all look about the same.

  They say by age 80 about 90% of the population will get Shingles. The vaccine can slow it down, but is no guarantee you won’t get it eventually. It is fairly rare on the face, which is why I got it there because I can’t never get things in a normal way.

  I believe the operation in April and the long recovery led to my immune system becoming weak enough so that the Shingles came out. I have asked several doctors if I could get it again. Some say yes, others say no one knows for sure and that it’s different on everyone. I haven’t heard anyone say that I couldn’t get it again. I don’t want it again.

  If you have had Shingles, you know what I’m talking about. If you haven’t, and you start breaking out without obvious reason in a pattern on one side of you body...see a doctor right away. Shots and meds can shorten the duration, but it will still have to run its course. In some people that can be months or even up to a year. If you get it in your eye, see a doctor right away because you can permanently damage your vision if Shingles goes untreated in the eye. I believe the long recovery caused the Shingle outbreak because of my weakened immune system.

  Shingles is some cruel stuff.

 

 

 

PTSD Review

I am often asked why some veterans receive a “Total and Permanent” rating on their first application for PTSD compensation. I’ve also recently heard from a vet who got 100% P&T on his first claim attempt. There is no real answer to that question because receiving 100% the first time around is a rare event. But there could be several reasons in such cases when they do occur.
A veteran may have a history of never being able to hold a job or even function in society. This would warrant 100% T&P. A veteran may have been treated in the system for years without ever filing a claim, but has an obvious sporadic employment record and a diagnosis of severe PTSD. This could also possibly warrant %100 P&T.

In rare cases, a veteran could have had such a horrible wound to the head or face that no one would hire him. Although, the wound wouldn’t rate total disability, the psychological damage of having to face the war each day from the disfiguring wound and not being able to secure employment because of the wound would rate 100% T&P for PTSD. If you have had a long term history of employment and are currently employed, getting 100% on an initial claim is not going to happen.

Some veterans worry that their PTSD percentage will be cut during yearly Comp Exams. This is not likely because PTSD does not go away. It may improve on a temporary basis, but it will never go away. Once you have a PTSD percentage, it will likely go up, and never go down.
Another veteran wanted to know if it is necessary to attend therapy to receive a service connection for PTSD.

After you are service-connected, it is up to you whether you want to continue therapy. If you intend to go for an increase, therapy is important because it shows you are seeking help. If you are satisfied with your percentage, you do not have to attend therapy. Therapy is something that should be done on an individual basis according to need. If you feel further therapy won’t help you, then go only when you feel the need to talk to someone. Once again, your percentage isn’t likely to be cut because you don’t want to see a therapist constantly.

Another veteran wanted to know if Unemployable veterans can get same day treatment at a VA Medical Center for a bad tooth, ingrown toenail, or a painful boil. You can receive treatment for all these conditions, but it is different at each VA Medical Center as far as immediate treatment. It would be best to call ahead and make sure you can get in on an emergency basis, and make sure you let them know you are 100%, especially for dental work.

Also, if you are in a Voc Rehab program, you receive treatment the same as 100% while you are in the program. If this is your case, I would request documentation from the Regional Office to allow emergency treatment, because if you just go in and say you are in Voc Rehab, the Medical Center won’t treat you without an okay from the Regional Office. Since this could take a month or longer, a bad tooth won’t wait that long.

Also, if you have a dental emergency while in Voc Rehab, call your service organization officer and they should be able to help you get in right away or you may also try your Voc Rehab case worker.

Finally, for veterans filing an initial claim, it would be best before you file to go to a VA Medical Center Out-Patient Clinic and request to talk to someone about PTSD. This gets it on record that you are seeking treatment and puts you in the system. You may also be able to get an immediate diagnosis of PTSD.

(The picture above was taken at the wall by another Marine Nam vet and childhood friend, Bill Maag. Thomas W. Mills was our childhood friend killed by a sniper around May of 1968. We called him Bo. During visitor day in boot camp, the DI screamed at me that my brother was here to see me. I didn't have a brother but I kept my mouth shut and went to the visitor center. It was Tom, down from Pendelton and pretending to be my brother. He bought me smokes and I had about three chocolate malts before the visit was over. That visit allowed me to make through the last few weeks of boot camp. I still think of him each day.)

Non-Taxable Military and Government Disability Pensions

Many pensions are non-taxable, and you often have to point it out to the IRS.

  Military and Government Disability Pensions

(from the IRS Code)

  Certain military and government disability pensions are not taxable.

  Service-connected disability. You may be able to exclude from income amounts you receive as a pension, annuity, or similar allowance for personal injury or sickness resulting from active service in one of the following government services.

The armed forces of any country.

The National Oceanic and Atmospheric Administration.

The Public Health Service.

The Foreign Service.

 

Conditions for exclusion. Do not include the disability payments in your income if any of the following conditions apply.

  You were entitled to receive a disability payment before September 25, 1975.

  You were a member of a listed government service or its reserve component, or were under a binding written commitment to become a member, on September 24, 1975.

  You receive the disability payments for a combat-related injury. This is a personal injury or sickness that:

  Results directly from armed conflict,  Takes place while you are engaged in extra-hazardous service,

  Takes place under conditions simulating war, including training exercises such as maneuvers, or

Is caused by an instrumentality of war.

  You would be entitled to receive disability compensation from the Department of Veterans Affairs (VA) if you filed an application for it. Your exclusion under this condition is equal to the amount you would be entitled to receive from the VA.

 

(If you receive one of the above pensions, especially, pensions at an outside company or other government job, which is not a VA service-connection pension, but based on a VA service-connected disability...then, you may have to point that out to the IRS. There are thousands of pages of IRS rules, and most of the employees don't know what all of them are. If you are currently paying taxes on a pensions that meets the above criteria, petition the IRS for tax relief under the code.)

 

 

 Amazon Books By Dennis Latham

B&N and Nook Books

email contact

 

Claims: Negative Side Effects Of PTSD Drugs

 

Can I claim any negative side effects from PTSD drugs for compensation purposes?

  (I asked a friend at the VA and here is the answer.) The answer to that is yes. The law was changed to state that drug and alcohol use can be a secondary consideration if used to tolerate symptoms of a service connected condition.

  So, that means if a veteran has a service connection for a condition such as PTSD... and if the veteran alleges that he uses pot and alcohol to tolerate his PTSD symptoms, perhaps to fall asleep or minimize nightmares, the chemical dependency may be considered a secondary condition that would actually increase the veteran's service connection rating. That is a radical departure from the traditional position that the V.A. has always taken regarding drug and alcohol use: that it was "misconduct". This will not be an easy claim increase, and I would expect delays. But receiving an increase is possible.

  The same would follow for drugs prescribed by the VA to treat PTSD. Some drugs do have serious side effects, and if those side effect lead to a serious condition, file a claim for that condition as secondary to PTSD treatment.

  The best thing to do is immediately report any side effects so the doctor can change the medicine.

  Also, always ask about the possible complications of mixing certain medicines. If you take other medicines, make sure each doctor knows what you’re taking because mixing certain drugs can cause serious side effects.

  Most Nam vets have reached the age where we all end up taking some kind of medicine for blood pressure, stomach problems, etc. Make sure to check all the side effects.

  If you take medicine, and you suddenly get the same medicine but it looks different, call and make sure you have the right medicine. The pharmacy can check to make sure you were not given the wrong pills by mistake or if the drug has a new manufacturer and a new shape.

  The VA contacted me by phone one time and told me to throw away a new bottle of medicine I had received. It was the right medicine, but in the wrong dosage. I’m glad they caught it because I wouldn’t have known I was taking twice the dose I should have been taking.

  The higher dose could have taken me out. I’m real careful now with any kind of medicine.

 

Two Marines KIA July 4, 1968

Chuck Searles and David Nelson were my friends.


45 Years Ago On July 4

Chuck and I were short timers in Nam, scheduled to rotate home in two weeks. I was going home with him to meet his parents in Burbank because we would be coming in through El Toro south of Los Angeles. We had a supply run to the firebase at An Hoa in the Arizona south of Danang. The Arizona was one of the baddest of all the bad places in Nam. I had been a 50 cal. gunner on the July 2nd run, and Chuck and David were assigned one of the gun trucks for the July 4th run. Chuck was an city boy and David was a farmer from Kansas.

 

They liked to argue with each other, in a good natured way, but at times they would get mad. This was one of those times. Since I got along with both of them, I decided I would make the trip as sort of an assistant gunner for Chuck to keep them from arguing. That was my excuse. I had a bad feeling about this run and wanted to be there.

 

We were on the gun truck and ready to join the formation when we got stopped by Captain Maggio, who ordered me off the truck. He said we were too short in-country and since I had been a gunner on the 2nd, he did not want to risk losing both of us. I guess he had a bad feeling about the run, too. I shook hands with both of them and laughed when I told them not to argue. They both just smiled at me.

 

"I'll see you when you get back tomorrow," I told them.

 

When leaving a base camp, the lead truck broke down and Chuck and David took the lead in their gun truck. The NVA ambushed them moments later with recoilless rifles, mortars and small arms fire. Chuck was hit and knocked from his gun and died in the truck bed. An enemy soldier ran from cover and dropped a grenade into David's lap, killing him in the cab. The enemy soldier was cut down by fire from the truck behind them.

 

If I had been on the truck, I would have died. For whatever reason, I had been spared. I feel it is my duty to keep their memory alive. They were young men in their early twenties. They had hopes and dreams like all young men, and they answered the call to duty.

 

It's been 45 years since that July 4th day, and their image has never left my mind. We honor them at our 7th Motors reunions along with our other 7th Motors KIA Marines, and in that sense, they are still alive and young and the way I remember them. We must never forget their sacrifice.

 

Semper Fi to my B Company brothers living and dead and to my belief in honor and duty. As long as there are those willing to make the ultimate sacrifice, I know America will always exist with our independence guaranteed.

 





Seeking Information On KIA

 

 

Seeking Information On KIA

 

 

John Gates Spindler

Date of Birth: 1 Feb 1946

St. Louis University High School: 1959-1963

Washington University: 1963-1967.  School of Business Administration.  BSBA 1967.  Beta Theta Pi Fraternity.

United States Marine Corps: 1965/6-21 Apr 1968.

Enlisted in the Platoon Leaders’ Class 1965/6 (Enl Ser No: 214(or 6)5520).

10-week Combined Course summer 1966.

Commissioned 2nd Lt USMCR on 6 Jun 1967 (Officer Ser No: 0102983).

Ordered to The Basic School (probably N or O Co, BOC 11 or 12-67) June 1967.

Graduated TBS Nov 1967.

Assigned to 3rd MarDiv with further assignment to G/2/3 as platoon leader.

KIA approximately 0830 (local) on 21 Apr 1968 while serving as 2nd Platoon Leader. 

 

What they are specifically trying to determine is his TBS class/company and anyone who might have a photograph.  They have both HS and college senior pictures but nothing of John in uniform of any kind.

Additionally, the Memorial Committee would like to invite anyone who served with him to attend the dedication.

 

If you can provide any information about Lt. Spindler or know someone in the following categories, please contact George at: VistanTN@BLomand.net

PH #: 931-307-9094 begin_of_the_skype_highlighting 931-307-9094 FREE  end_of_the_skype_highlighting

 

Anyone in TBS class that convened in June or July, 1967;

Anyone who went through the Infantry Officers Course with that folks from those classes; or

Anyone who was in, attached to, or supported 2nd Bn, 3rd Marines in RVN Jan-Apr 1968.

 

Thanks for any & all assistance!

Sleep Apnea Can Cause Major Problems

Sleep Apnea

Two of the major indicators for sleep apnea (snoring or holding your breath) are neck size and body mass index. As many as 75% of professional football players, and many college and even high school players, qualify for the neck size indicator, which is 18 inches. And despite being in sensational football condition, many qualify for the body mass index indicator, which is 30 and above.

  I have a large neck and head. It’s always been hard to hurt me by hitting me in the head, which has made me the topic of many jokes. I didn’t snore; I held my breath and made zoo noises, from growls to shrieks and everything in between. My family thought I was possessed. I’ve had sleep apnea for years and I use the CPAP, which can be a real pain. It’s a machine that forces air down your throat through a mask so you don’t hold your breath. For veterans who don’t have a 50% or more service connection, being diagnosed with sleep apnea can be a big expense if you lack health insurance.

  The machine cost about $2000 and the doctor visits to determine if you have sleep apnea probably cost about the same. I got my machine through private health insurance because I didn’t know the VA could help me with the sleep disorder. Now, I see the VA chest doctor and they replace my mask and heated water container and maintain my machine when necessary.

  I don’t hold my breath at night anymore, at least, most of the time, but my sleep isn’t any better. I still wake up every few hours, and I don’t sleep anymore than I did without the mask. This tells me that a lot of my problem is Nam related because my survival instinct never really shuts down. I usually catnap during the day without the mask.

  The mask takes time to become routine and made me feel like some weird astronaut. The only other alternative, because the base of my tongue is huge, was an operation that isn’t guaranteed to work. The doctor also told me it would make my chin pointed because they would have to remove half of my chin. They said I would probably look different. That went over big. At my age, I’m kind of used to my own weird face and I didn’t care to walk around looking like somebody else. So I passed on any kind of surgery.

   I did meet a veteran who had the surgery, and it worked for awhile but now he has problems again. It’s best just to get the mask and CPAP and deal with it. Then, if you don’t like it or don’t want to use it, you have the option to stop. But if you have the symptoms get checked out because untreated sleep apnea can cause other health problems.


Dennis Latham Books

 

 

 

At The PTSD Comp Exam

My childhood friend who didn't make it home. He got me to join the Marines.

 

At The PTSD Comp Exam

  For the PTSD, you will talk to a shrink. The shrink must be a medical doctor so it should be a psychiatrist and not a psychologist or a social worker. If it isn't a psychiatrist and they turn you down, then disagree on the grounds that it's not a valid comp exam.

  The shrink will talk to you, write a report and you should hear in a few months. They take the report and use the available evidence and make a decision, which will go all the way back to when you filed as long as the claim didn't lapse in between while waiting. The entire PTSD rating is always based on your ability to support yourself when compared to non-veterans.

  I would stress that you have problems working with others, whether you do or not, which you probably do anyway if you have PTSD. This can mean the difference between the 30 and 50 percent rating. Tell them if your employment has been scattered, and you believe it's due to your PTSD, which it may be.

  People with PTSD often don't realize the root causes. Don't give them anything they can use against you, like any childhood abuse. Tell them your childhood was normal and you didn't have problems until the military. They will try to use anything before service as a cause of PTSD. I believe they will probably service connect you at least 30 and maybe 50 on the first round. If you get 50, then disagree after you get your pay and go for 70%. Once you are 70%, they have to consider you for unemployabilty.

   Anything, and I mean anything, that happened before your military service will be used against you if it is a negative.

  You want to prove that the PTSD was caused by and aggravated by your time in the military. If you meet all the criteria, now all you need is the comp exam shrink to agree. It's a good sign if you are in there for over 30 minutes or so. They must also ask you about the issues which you think caused your PTSD while in the military. They may also give you a GAF score. (General Activity Function) or (Global Assessment Function). This rating can be different on each visit, but the VA tries to use it against you if it's high (50 on up). The ideal GAF for PTSD is around 40. Below that and you are almost in a vegetable state, according to the scale.

  The GAF cannot be used against you because it is one person's opinion and can change from day to day. The VA always states it is not your adversary, but on claims, they are, always.

 

 

 Michael In Hell (my PTSD novel)