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Dbltap1 wrote:

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In another post someone wrote that it's so easy one would need to be severely mentally challenged to really need to hire an attorney.... Well, I resemble that remark!

I received my denial letter last week so I started putting together my own SR. If anyone has the time to proof read and respond it would be greatly appreciated. No rush. I prolly won't send it off until I talk myself out of it then back into it a few more times.

Name   SSN   DOB

XX Years of military service

My Medical and Mental Disorders:

Post-traumatic Stress Disorder (From SSDI Blue Book: Anxiety Disorders 12.06): I served with the US Army in South West Asia (2/2003-3/2004) I was a Mobile Interrogation Team Leader during the deployment. I have had interaction with insurgents during dismounted patrols, cordon and searches, security details and while performing the military equivalent of search warrants and arrest warrants followed by hours and days of interviews and interrogations. Wherever these search and arrest type operations were, my team was called on to assist combat teams in locating and capturing key enemy personnel.  I was in charge of from 4 to 20 personnel, both civilian and military. It was my responsibility to complete our missions and keep my team safe. I am frequently concerned with how or what I could have done differently to lessen the number of attacks on American troops. It was my responsibility to find out who was leading and planning the attacks, who was supplying weapons and who or what was the next target. I have assisted medics in treating wounded soldiers. I was exposed to mortars, RPGs, IED explosions and shot at directly. I have attended memorial services for soldiers killed in combat. I have witnessed burned, mangled and mutilated bodies. I had endured a great deal of sleep deprivation during deployment. The events during the deployment caused fear, helplessness and horror. I started experiencing anxiety symptoms during deployment. I have constant recurrent and intrusive recollections of combat operations, including images, thoughts and perceptions. I experience intense anxiety to exposure to internal (when my heart starts pounding for an unknown reason, it reminds me of events, then it starts pounding harder) and external reminders that symbolize or resemble various aspects of the past traumatic events. I struggle to avoid activities, places, people, sounds and smells that remind me of events and locations of combat operations. I have little to no interest in participation of activities that were of value to me prior to the deployment. I have feelings of detachment and distance from others like I do not belong. I have difficulty in falling and staying asleep. Most of the sleep I do have is restless to the point that I feel that I don’t sleep at all because I can still hear activities around me. Sound keeps me awake yet I feel I must have bedroom windows open, even through the winter, so that I can hear what is happening outside. I experience irritability, depressed mood, lack of motivation, lack of pleasure, difficulty concentrating, hypervigilance and exaggerated startle response. I experience increased anxiety in crowds or any area where people are shouting, joking, horseplaying or goofing around. These activities around me cause me to be on guard for an argument or altercation. Sudden loud noises also remind me of past events. I have poor frustration tolerance with people. I get angry easily with people. I get angry or frustrated with peoples meaningless conversations, disagreements or even their simple pointless banter.

I find isolation more preferable to interactions with others. I tend to avoid even people in small numbers that are loud or distracting to the point that I cannot monitor all events that could affect me or those that I care about. Crowds, people and situations that do not provide me an opportunity to monitor everything nearby sends me into an anxiety episode and I lose concentration. I have a sense of detachment from others and do not seek to interact with anyone.

These symptoms have been diagnosed by military and civilian physicians in the past.

Occupational Limitations: I have continuous, intrusive, day dream like experiences. These occur during the day and night. Because of this I continually mix things up and have to continually correct my errors. I get angry with people easily. Interoffice hostility results in an uncomfortable workplace for everyone. It is difficult to perform my professional responsibilities out of fear that I may make a critical mistake causing harm to another individual. I have found that participating in my professional employment exacerbates my stress, mental disorders generating panic attacks, and depressive episodes. Memory problems that are secondary to PTSD cause an inability to adapt to changes at work such as new procedures or to learn how to operate new equipment. Because of the social distance I keep and the eventual distance other keep from me, I am always “out of the loop” with what is going on. The military has moved me to multiple different agencies and locations in efforts to try and find an environment I can work in.  They eventually had no other option than to medically retire me.

I have come to realize that I can no longer work in my profession because of these issues and my preoccupation with intrusive thoughts concerning my experiences in the Middle East.  These intrusive thoughts have been present since I came home and have grown in intensity. I constantly daydream about events and experiences of my time in a combat environment.

In my recent military mental health evaluation, the examiner stated "residual anxiety symptoms cause clinically significant distress and impairment in the realms of social and occupational functioning.” And “Impairment for social and industrial adaptability is definite.”

TREATMENT: My treatment began as early as 2008 by Dr. XXXX or XXXXX, Psychiatrist in the XXXXX, CA area. We could not get along so I chose to stop seeing him. Visits with him only made me feel worse. Later, I saw a counselor familiar with veterans’ issues who gave me some tools to help deal with family and work issues and suggested a different doctor. I eventually settled in with Dr. XXXXXwho I have been comfortable with.

I have been prescribed Lexapro, Prestiq, Abilify, Saphris, Cymbalta, Trazadone, Klonopin, Lorazapam and Temazapam.  I currently take Cymbalta, Abilify, Trazadone, Klonopin, Lorazapam and Tamazapam. Some of these medications leave me feeling foggy and surreal.

Major Depression (Affective Disorders 12.04): I have a history of depression secondary to Post-traumatic Stress Disorder.

Occupational Limitations: I have loss of interest in activities, psychomotor agitation, lack of energy, feelings of guilt, sadness more days than not, suicidal ideation, and sleep disturbance. It causes difficulty in concentration and persistence, difficulty maintaining social functioning, and a diminished drive to complete any daily activities. These symptoms have been diagnosed by military and civilian physicians in the past.

Treatment: I have been prescribed Abilify


Hypertension (Cardiovascular System 4.00): I was diagnosed with hypertension in 2008 with frequent readings in the area of 160/110.

Occupational Limitations: Hypertension causes lightheadedness, headaches, weakness, fatigue and frequently my vision gets blurry. Stress and anxiety contribute to the raising of blood pressure.

Treatment: I currently take Lisinipril daily to control blood pressure. Without medications, my blood pressure elevates to abnormal levels.

Piriformis Syndrome (Musculoskeletal System 1.00 ): Because of a Line of Duty accident while on active duty, I suffered an impact injury to my right hip / groin area resulting in muscle and nerve damage along with a labral tear. The Piriformis muscle certainly has a purpose however from my understanding it must be minimal as some of my doctors have discussed the possibility of having it removed. However, the doctors that have stated this also agree that there is a possibility that it may not benefit the nerve entrapment.

Occupational Limitations: This injury has been continuously aggravated by simple daily activities and limiting my range of motion and ability to sit or stand for more than 15 minutes.

Treatment: In the past 7 years, I have received various treatments including numerous cortisone injections and for the past four years I have undergone outpatient surgical procedures of injections of botulism toxin on average of every three months into this muscle group. Oral medications include Vicodin, Endocet, Oxycodone, and Flexaril stop the pain.

Iliopsoas Syndrome  (Musculoskeletal System 1.00 ): Because of a Line of Duty accident while on active duty, I suffered an impact injury to my right hip / groin area resulting in muscle and nerve damage along with a labral tear. Iliopsoas bursitis and tendonitis are constantly aggravated as this muscle group nearly impossible to isolate for any period of time to allow any meaning healing time.

Occupational Limitations: The Iliopsoas group is used while standing and walking as well as movement into or out of a seated position. This injury has been continuously aggravated by simple daily activities and limiting my range of motion and ability to sit or stand for more than 15 minutes.

Treatment: In the past 7 years, I have received various treatments including numerous cortisone injections and for the past four years I have undergone outpatient surgical procedures of injections of botulism toxin on average of every three months into this muscle group. Oral medications include Vicodin, Endocet, Oxycodone, and Flexaril stop the pain.

Degenerative Disk Disease Lower Back (Musculoskeletal System 1.00 ): Age and regular wear and tear of carrying a battle load has surely added to this condition.

Occupational Limitations: This injury has been continuously aggravated by simple daily activities and limiting my range of motion and ability to lift, twist or stand for more than 15 minutes.

Treatment: Oral medications include Vicodin, Endocet, Oxycodone, and Flexaril stop the pain.

Sciatic Neuralgia (Musculoskeletal System 1.00 ): The exact etiology is unknown as this could be caused by any one of the previously listed three condition or all three to some degree.

Occupational Limitations: This injury has been continuously aggravated by simple daily activities and limiting my range of motion and ability to ability to lift, twist, sit or stand for more than 15 minutes.

Treatment: In the past 7 years, I have received various treatments from two major hip surgeries to numerous cortisone injections and for the past four years I have undergone outpatient surgical procedures of injections of botulism toxin on average of every three months. Oral medications include Vicodin, Endocet, Oxycodone, and Flexaril stop the pain.

Degenerative Arthritis of the Right Hip (Musculoskeletal System 1.00 ): Because of a Line of Duty accident while on active duty, I suffered an impact injury to my right hip / groin area resulting in muscle and nerve damage along with a labral tear. The surgeon stated “the cartilage in the hip socket is barely attached.” After the last surgery I was placed on a “No weight bearing” restriction for six weeks.

Occupational Limitations: This injury has been continuously aggravated by simple daily activities and limiting my range of motion and ability to sit or stand for more than 15 minutes.

Treatment: In the past 7 years, I have received various treatments from two major hip surgeries to numerous cortisone injections and for the past four years I have undergone outpatient surgical procedures of injections of botulism toxin on average of every three months into this muscle group. Oral medications include Vicodin, Endocet, Oxycodone, and Flexaril stop the pain.

Mid Back Pain (Musculoskeletal System 1.00 ): Because of a motor vehicle accident while on active duty, I suffered an injury to my mid back from bouncing into the air while riding in the back of a military vehicle and landing on boxes as well as the bed and side rail of the vehicle. 

Occupational Limitations: This injury has been continuously aggravated by simple daily activities and limiting my range of motion and ability to ability to twist, sit or stand for more than 15 minutes. Additionally, it is aggravated by raising my arms above my head, seated at a desk or counter and activities where I must slightly lean forward.

Treatment: In the past 8 years, I have received instruction on therapeutic exercises to perform. Oral medications include Vicodin, Endocet, Oxycodone, and Flexaril stop the pain.

 

Bilateral Pes Planus- plantar Fasciitis and posterior tibial tendonitis (Musculoskeletal System 1.00 ): These issues started in the mid 1990s with occasional pain and discomfort. Because of military issued soft desert boots with no arch support the pain increased rapidly as I developed “Adult Acquired Flat Feet” caused by the lack of arch support, soft sand and a heavy battle load. I refer to this issue as “my chicken or my egg.” There are rare days that I can wake up and before moving feel relatively good physically. Then as I get out of bed I get the faithful twinge of pain from either the two inguinal hernias, low back, mid back, iliopsoas group or sciatica and piriformis, plantar fasciitis, posterior tibial tendonitis or maybe no pain at all. Then I get to guess if is going to be “the chicken or the egg.” Will the pain start at the top and work down or will it start at the bottom and work up, as my feet hit the floor?

Occupational Limitations: This injury has been continuously aggravated by simple daily activities and limiting my ability to walk, run or stand.

Treatment: In the past 17 years, I have received various treatments including cortisone injections and instructions on therapeutic exercises to perform. Oral medications include Vicodin, Endocet, Oxycodone, and Flexaril stop the pain. Issued othotics twice. Treatment is not correcting the problem, it only lessens the severity sometimes.

Left Biceps tear and Tendonitis (Musculoskeletal System 1.00 ): While lifting weights for military physical fitness, I tore my left bicep and developed tendonitis. While lifting I had reached muscle failure and started to set the dumbbells on the floor when I noticed that another gym member was not paying attention and had his right leg and foot underneath my inclined bench. To avoid dropping the weight on him I rolled my arm improperly to put the weight down. I heard and felt a loud pop. Later evaluation and imaging showed a partial tear.

Occupational Limitations: Minimal. Left wrist condition generally limits overuse of left bicep. However, when it does flare up it is painful and therefore adds to the mood swings and depression as it is just one more thing in my life that is failing.

Treatment: Ice and rest as needed.

Left wrist arthritis (Musculoskeletal System 1.00 ): Because of a Line of Duty accident while on active duty, I suffered an injury to my left wrist resulting in an fracture of the Ulna and various tears of connective tissue within the wrist. The first surgery was performed in 2005 during which a plate along with pins and screws were put in place to hold the pieces while healing. In 2007 the plate was removed because of improper alignment caused the tendons to track improperly. Also in 2007 arthroscopic surgery was performed debridement of the connective tissue within the wrist and ultimately a neurectomy was performed.  Lengthy rehabilitation was carried out to regain motor skills. While the wrist is functional I do not have full range of motion, it frequently aches and is more often than not the wrist and hand is nearly ice cold.

Occupational Limitations: Grip strength is relatively good however, this injury has been continuously aggravated by simple daily activities and limiting my range of motion and ability to grip while twisting and painful to place any pressure while palm down.

Treatment: Oral medications include Vicodin, Endocet, Oxycodone, and Flexaril stop the pain.

Left Nostril obstruction (Respiratory 3.00): Because of a spider bite on the inside of my left nostril while on active duty residual scarring has nearly completely obstructed breathing through the left nostril.

Occupational Limitations: This combined with Allergic Rhinitis causes difficulty breathing and exacerbates the frustration, fatigue and irritability brought on by the rest of my mental and physical problems.

Treatment: Oral medications included antibiotics.

 

Allergic Rhinitis and undiagnosed breathing conditions (Respiratory 3.00): I have always had severe allergies to seasonal pollens and pollutants.  While on active duty, during deployment in the Middle East, I was stationed at Balad Airfield during the last six months of deployment. While I was not there constantly, I was there frequently and did have my share of time at the famous Burn Pits.  

Occupational Limitations: This combined with the left nostril obstruction causes difficulty breathing and exacerbates the frustration, fatigue and irritability brought on by the rest of my mental and physical problems.

Treatment: Weekly injections

In conclusion, I have been told by DAV and VA personnel that I will likely be rated 100% Permanent and Total by the Veterans Administration with a designation of Individual Unemployability. By this designation and thier acknowledgement that the VA probably won't finish this claim in the next 12 months, it is deemed that my medical and mental disorders will not improve in the next 12 months and will likely continue for my lifetime. I am 44 years of age and contend my disabilities are progressing and will not improve. The mental disabilities originated in 2003-2004 and show only intermittent and temporary signs of maintaining the same level of disabiling episodes. More days than less, the episodes gradually seem to get worse. Most of the physical disabilities originated in the mid 2000s and while their effects have changed they have not improved and are not likely to. Cartilage does not grow back once gone, degeneration does not regenerate, arthritis does not just go away and tendonitis is always waiting to flare up.

My medical disorders have progressively worsened to the point that I cannot do the physical things that I used to do without agonizing pain and discomfort and the mental disorders have worsened to the level than I cannot do the more detailed, critical and frequently socially oriented work that I have done in more recent years. Therefore, I request that my claim for SSDI be approved.

 The End

Any corrections would be apreciated. Thanks everyone!