For U.S. veterans who have or will be filing a VA disability compensation claim for posttraumatic stress disorder (PTSD), here is the first in a series of posts offering advice on how to prepare for VA Compensation and Pension exams (C&P exams). [Two subsequent posts are: Advice for Veterans – VA PTSD Compensation and Pension Exam and Advice for Veterans – PTSD Military Sexual Trauma (MST) C&P Exams.]
#1 Keep a Symptom Diary
Keep a diary or journal for at least two weeks in which you describe experiences related to the trauma(s) you suffered.
Some experiences are obviously trauma-related, such as:
- nightmares about the trauma(s)
- painful memories that seem to come from out of the blue or are triggered by something you see, hear, or smell
- constantly feeling ‘on guard’ and alert to possible danger
Other experiences might not seem related to PTSD at first, such as:
- frequently getting into arguments with your spouse
- feeling really tired and worn out all the time
- feeling ‘flat’ or ’empty’, like emotions have been drained out of you
You therefore should educate yourself about the symptoms of posttraumatic stress disorder, if you have not already done so. You will then recognize symptoms such as:
- irritability and anger outbursts
- insomnia, poor quality sleep, and fatigue
I suggest reading the official PTSD diagnostic criteria, as well as PTSD symptom descriptions written in everyday language. You want to familiarize yourself with PTSD symptoms and their effects so that you will recognize them in your day-to-day life and record them in your journal. On the other hand, don’t start to use words or terminology in your diary that you would not use in normal conversation. For example:
Do not write something like this: I had marked physiological reactivity today when exposed to trauma-related stimuli–the smell of diesel fuel–and I had constricted affect even when my daughter hugged me when I came home from work.
Do write something like this: A truck passed me on the way to work today with a strong diesel smell and before I even realized what was happening my heart started pounding, I got all sweaty, and I felt like I was going to have a bad anxiety attack so I pulled over and called my wife and she helped calm me down and I realized how the diesel smell made me feel like I was back driving in a convoy. Later in the day when I came home from work, my 4 year old daughter came running up to me yelling, “Daddy’s home! Daddy’s home!” and I was sure glad to see her and she jumped up and wrapped her arms around my neck as I bent down, but it was so weird because I felt this blank feeling, like I know I love her so much, but it was like the feeling of love had shrunk or was hiding or something. It was a strange and bad thing to not feel the way I used to before my deployment.
Ask your spouse or other family member to also keep a diary.
Make copies of the diary and give it to the psychologist or psychiatrist who does your C&P exam and send a copy to the VBA Regional Office handling your claim. Remember when you mail documents to the VARO (VA Regional Office) to always send it in a way that gives you proof that they received it, e.g., FedEx, UPS, U.S. Postal Service, Certified Mail, Return Receipt Requested. It’s not that VBA officials are up to no good; it’s simply a big bureaucracy and you want to have proof that they received your documents.
What do you think? What advice would you offer veterans? Please comment below!