mental health C&P

sparky_wulf

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Alright - since this is a mental health thread it's okay for me to say that I'm completely flipping out about my not scheduled yet C&P exam, right?!

What should I expect at this? Is it just running through a checklist?

I'm afraid of being interviewed in terms of only PTSD - and although I do have a little PTSD from a sexual assault from before I was in the service - my conditions are not of a mental health area that would typically be expected from an MEB patient.

Would it be appropriate for me to bring along a list of talking points or a list of my symptoms?
 
Be sure to be able to talk about each of the symptoms and how it effects your life. The key to a mental heal CP exam is the occupational and social impairment statement that the examiner will check only one block it will be section 4a of the following form: http://www.vba.va.gov/pubs/form
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 medication0


s/VBA-21-0960P-3-ARE.pdf

The supporting statements in the rest of the DBQ will support this one key statement in 4a that will get you a rating.


the VASRD mental health criteria are below:
 
Now to put it into perpective for your Case personally. Look at the 50 and 70 % statements above dealing with relationships. One says "difficult establishing and maintaining relationships" and the other says "inability to establish and maintain relationships".

So which one applies to you? I leaned more toward the inability because I had began terminating relationships dues to severe anxiety, including with my own mother and best friend from high school. Be prepared to just tell the doc something like this:

I am having trouble with relationships. I no longer seek out new ones and I am terminating existing ones. The doc will likely ask about work relationships too. Be prepared to talk about anything that is on that form I posted a link to. Be prepared to discuss with the doc how you fit into the criteria and supporting statements. You've got to be a poker player too, Don't give away your hand and tell him you've read the DBQ and when you discuss the the above stuff don't use the exact VA verbiage.

Also be aware they will try and trick you. My CP examiner told me a joke. I didn't luagh but in his report he said I smiled and luaghed easily. They will annotate your mood too. If you go in there acting normal they will say it is euthmyic (positive mood).

In short, prepare and be able to talk about how you fit certain criteria they are looking for in occupational and social impairment terms (work and relationship terms) without using thier exact wording.
 
What should I expect at this? Is it just running through a checklist?

I'm afraid of being interviewed in terms of only PTSD - and although I do have a little PTSD from a sexual assault from before I was in the service - my conditions are not of a mental health area that would typically be expected from an MEB patient.

Here is a copy of the DBQ for PTSD http://www.vba.va.gov/pubs/forms/VBA-21-0960P-3-ARE.pdf

The provider will review (typically in advance) your behavioral health history that is in your MEB packet. What they see may or may not be current, they only have access to what the VA provides them through their relationship with the PEBLO and VA.

You may want to consider reviewing what the LA AFB has on record for you in AHLTA. If you have any treatment notes outside of the AHLTA notes, you will want to have them scanned into the system.

When you meet with the provider, they are going to do what is called a biopsychosocial assessment. The provider will use all available evidence to make their assessment. This may include what you say, how you look, how you act and of course and historical evidence.

As stated earlier, your rating is mostly going to be derived from the occupational and social impairment statement that is checked in section 4A. of the DBQ.

There is also a PTSD diagnostic criteria section in the DBQ which will address 5 different criterions of PTSD. The DSM-IV is used during this process and it has a slightly different interpretation of PTSD that civilian providers do if they base their diagnosis on the DSM-V.

The whole process takes about 60-90 minutes and is virtually painless.
 
This points directly at my concern... my issues are primarily not from PTSD.
 
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