Here be the third installment of this PTSD focused portion of the Tough Shit Series. To sum up the previous two chapters, I had lived a somewhat crazy life for 14 years. It started off as a soldier in a combat zone, and kept rolling as a SWAT cop in a big city. Last time we ended with me leaving the SWAT team due to severe burnout, and moving to an admin position within my department. About six months after leaving the team, this happened:
One day I was walking to my office downtown and was waiting at the crosswalk for the signal to change. The guy waiting next to me worked for the city as a veteran advocate, said his name was Barry, and asked if I had served too. That led to him prodding me to file for disability benefits. I relayed that after leaving the Army, at the recommendation of other vets, I had indeed filed for them. I’d been given a small disability rating for hearing issues due to firing machine guns and being around explosions without hearing protection. I had a few other lingering physical issues that were an annoyance yet didn’t get rated, but didn’t feel like pushing the matter and therefore having to deal with the VA. Barry asked what specifically I did in the army and where I served. “Infantry, Afghanistan” I replied. He asked if I got a CIB while over there, an acronym for Combat Infantryman Badge, earned for being in some sort of shit. I replied in the affirmative, but sheepishly said that the stuff I did to get in was relatively minor(see the previous post for plenty of information on all that). Barry looked at me like I was an idiot “so you’re telling me you earned a CIB and didn’t file for PTSD? Bro, you realize if you’re rated for PTSD you can get help whenever you need it, right?”. I weakly demurred that I was fine, and didn’t presently require any help. Judging by the look Barry shot at me, I think he’s either quite perceptive or I’m just an open book. “Whatever man, you change your mind, here’s the number of a guy who can help you with a VA claim” he said while passing me a card.
It took some months of me thinking about all of this. I was in a comparatively better place, with a much more reasonable work schedule. But I knew everything was not perfect. I left a job I loved for a mind numbing admin gig, largely because the constant call outs and stressful incidents led to burnout. I knew I still had lingering psychological issues likely caused by police related shit, which was built upon the shaky foundation that was my Afghanistan shit. Maybe if I could deal with the root cause, I could get back to doing cop work I actually enjoyed?
Though the intensity of my afghanistan flashbacks were dialed down, they now were part of a larger tumbler of other shit I‘d experienced more recently in the police world, which popped up occasionally to fuck with me. I finally had the time to sleep, but it was of crap quality at least half the time. Some of that stuff would wake me up in the middle of the night; I’d spring out of bed with my heart racing and there would be no getting back to bed.
This was happening even though I’d long since gone on the offensive for the mental self care stuff. Read lots of books, listened to all the podcasts, and did what the therapists told me to do. For years I’ve been working out regularly, meditating, restricting alcohol, doing yoga, eating healthy; doing all of the things. Despite this, I knew I was not the best version of myself. I was frequently irritable, and would get unreasonably angry for no reason. I was also underwhelmed with the therapy the police department offered. Besides being restricted to six sessions each time I requested help, I’d never seen the same therapist twice. The nonprofit I’d gone to initially was low on funding, so I was completely dependent on my city provided care. I’d also heard that many paid therapists were primarily trained on helping people with non-combat related issues, so I’d likely have to wade through more than a few to find a good fit.
Finally, I made the call. Having help there for me whenever I needed it provided by people who dealt with only the issues I was having sold me. Maybe I could become a better person for my wife and kids. Shit, maybe I could be a better person for myself. Barry hooked me up with another vet named Bryan, a Veteran Service Officer that helped with filing claims. I explained that I wanted to file for PTSD, wrote out my symptoms, and he sent it up.
The VA rates people on their level of disability by a percentage basis. If I understand correctly, the percentage means how much more difficult the disability makes your life and ability to work. It ranges from 10% to 100%; you can even get rated at 0%, which means that your issue was caused by your service and you therefore qualify for VA provided care for said issue, but it has little impact on your life. Unlike other disability systems, 100% VA disability doesn’t mean you can’t work, it just means your injury makes it 100% more difficult. I figured at most I would get rated at 10% for PTSD, maybe just 0%. I didn’t really care, I just wanted access to help. During the claim process, the VA had me sit down with a legit PhD trained Psychologist to determine how much my PTSD was rated at. This was new for me, before all of the therapists that helped had masters degrees in therapy. I was interested to hear her insights given her greater level of training.
It was a pretty standard interview. The psychiatrist in this case was there to evaluate me, not help. She ran me through a checklist of symptoms, and I described which ones I had and how they affected me. She went through a list of possible traumatic incidents that could have occured to me when I had served, and I answered with the ones I’d experienced. Once again, I had to describe the human trafficking situation, watching soldeirs burn alive, watching civilians getting inadvertanly vaporized, and the various times we’d taken direct fire, indirect fired, and near misses with IEDs. It didn’t really bother me describing the times we’d been in spots where our lives were at risk, but describing incidents where I watched others suffer fucked me up. Like I wanted to hurl and break down at the same time. Hell, even now just writing that last little bit I can feel my stomach tightening. Blah. Anywho, I didn’t really think any of that stuff I told the psychiatrist was that big of a deal, especially in comparison to all of the other hard core combat that this lady probably heard about all of the time. Besides the feeling like crap while describing the above, overall the evaluation was pleasant. She seemed like a nice person, committed to assisting the VA system help those that needed it. We said bye to each other, and as I left the session I figured it’d be even money that I’d get 10% or 0%. Didn’t really think it was that big a deal, I figured worst case the VA wouldn’t rate my PTSD and I’d just shop around for a therapist before leaving the police department someday.
About a week later I got a letter in the mail from the VA. It was all official, and initially my thoughts reflected my previous ones; something like “bet they didn’t rate me, oh well”. But as I read it I couldn’t believe what they were saying. Turns out the psychiatrist rated my PTSD at a 50% level, and now combined with my hearing issue my total disability rating was 60%. Shock hit. I read it at least three more times just to make sure I hadn’t had an aneurysm or forgotten how to read numbers. Surely they were mistaken. But the letter listed the above ratings, and made it clear that this was the VA’s final determination. It said nothing as to why I was rated so high. I went to the VA website, and checked my online profile with them. It said the same thing; 60% total rating, 50% of which was for PTSD, and no further info. This was disconcerting to say the least. I didn’t feel like I was 50% disabled due to PTSD. Given, I had no idea what that meant, but it didn’t feel right.
Now I must mention that before going into this rating process, I had purposefully NOT googled anything about it. I’d heard rumors of other vets out there trying to game the system by memorizing the right things to say to get their PTSD rated as high as possible. In addition to medical care for whatever disability the VA rates you as having, you also get tax free compensation in direct relation to how high you’re rated. So the higher the rating, the more money they send you. This apparently has motivated more than a few vets to play up their symptoms, or even just make them up, to try and get more benefits. I’m pretty opposed to this for a variety of reasons, largely summed up as I don’t think it’s the right thing to do. I wanted to make sure I wasn’t even unconsciously tempted to do this, so prior to my eval I didn’t look up what symptoms were correlated to each percentage level the VA rated PTSD at. Getting rated at 50% for PTSD freaked me out. Was there actually something wrong with me? Off to google I went.
As I suspected, the first few results were all about how to get your PTSD rating higher so you could get more money. Bleh. Finally I found a chart that actually described what symptoms were associated with each level of rating. Reading the 50% level, I was like “huh, I guess that is where I’m at. Weird?”. The next thought I had was that such a high rating must mean that perhaps this PTSD thing was affecting my life more than I thought. So my mind went to the next logical step-ok, let’s deal with this and figure out how to fix this shit. I went back to the letter the VA sent me; surely they would list a number that could get me in for some PTSD focused therapy or something. Nope. The first page described in detail what my rating was, the second page listed how much they would pay me and how to appeal my claim, the third was a statement of my rights…ah, finally halfway down on page four there was a small link to a web portal that sounded like it had something to do with mental health.
I went to the web portal, and after making a new account, verifying a bunch of stuff, I finally navigated my virtual ass to a page listing a number to call. Ok. Called the number, and told them I’d like to get some help for this PTSD thing I was just rated for. The lady on the other end was nice, but said before I could get any mental health care, I would first have to make an appointment with a General Practitioner Medical Doctor. The Doc could then refer me to Mental Health. I asked if she could set up such an appointment, and she said they were pretty backed up and it’d be at least a month or so. She then put me on hold while transferring me to scheduling. While listening to muzak and waiting, I distinctly remember thinking “thank God I’m not thinking about killing myself-I’d be fucked!”. Talked with the scheduler, who again was super nice. Got an appointment for about two months later.
After hanging up, the ridiculousness of the whole process hit me. So, a government provided psychiatrist says I have a pretty high level of PTSD, which is directly related to services I performed for same government. This government then sends me a letter, basically saying
“hey, we think you’re kinda fucked up mentally for some shit you did for us, here’s some money! Now here’s a few pages of legal jargon! Ummm, I guess if you want help go to this website, but you’ll have to jump through a bunch of hoops and it will be months before we let you see an actual person that can maybe help you or whatever.”
I shouldn’t have been surprised; I’ve worked for various levels of the government my entire life. Most people are trying to do the right thing, but it’s a giant organization with multiple checks and balances to mitigate the abuse of power but inhibit efficiency. I was beginning to understand why I’ve heard so many vets complain about the VA. And it was just getting started.
A few months later, I get into see the VA GP Doc. Cool dude, and everyone else working there seemed to give a shit. Like really, they were all nice, knowledgeable, and helpful. As my exam was finishing up, I mentioned that I would like some mental health care for this PTSD thing I’m rated for. They almost seemed surprised, but said they’d refer me and someone from the Mental Health office would be in touch. A week or so later, a scheduler from Mental Health called, and got me a virtual screening appointment the following month. This screener would figure out what services would be best for me. I asked “couldn’t you just use the information from my rating session?”. Nope, two completely different systems.
The next month I had the screening meeting. Nice person, and we basically rehashed everything the Physiatrist who rated me had gone over. As before, going over this stuff messed me up and I felt like I was in a gray haze for the rest of the day. We finished up, and they said I’d be a good candidate for the trauma program, but the next cohort wouldn’t start for months. In the meantime, I could get help from another staff therapist until the program started. This bridge therapy (bridge between now and the trauma program) could start in a couple of weeks.
Started bridge therapy. Guess what was the first thing we did? Went over the exact same incidents the screener and the rater had gone over. Again, felt all fucked up the rest of the day and slept like shit. Other therapists have told me there’s this thing called exposure therapy, where you talk about a traumatic incident over and over until it’s lost its sting. 1. If that was the intent of this whole process, it sure wasn’t working. I felt worse each time I had to describe the same incidents. And 2. This was definitely not an intentional process; it was a feature of an inefficient system. And it was fucking me up.
A few sessions into my bridge therapy, I got a call from a VA scheduler saying that my current bridge therapist was unavailable in the future and asked if I would like to schedule with someone else. Sure. Hey, guess what the new therapist had me describe in my first session with them? Fuck…..
I stuck with that therapist for a few more months. They were nice, but they just talked me through all of the coping skills I’d learned from previous therapists and my research. Yup, concentrate on breathing. Meditatate. Avoid abusing substances. Check, check, and check. Felt like treading water. Not getting any worse, not getting better.
Finally the trauma program started. This was an intense 3 month long program with weekly sessions and lengthy homework. If up until now this post seems like it’s spiraled into me complaining about the VA, then we’re on the same page. I never wanted to be one of those vets screaming “fuck the VA!!!”, but man the constant repetition of describing the incident which I believed led to me needing therapy got pretty damn mind wrecking.
It got better, eventually. The trauma program was a bitch. It was not enjoyable, and the aftermath left me adrift. So adrift it led to me coming to terms with lingering suicidal ideation ( see Chapter 1) that I’d been repressing for years. Finally coming to terms with that and other issues ending up being a net positive though, and I credit the trauma program with that. One of the positives was realizing I was way oversaving, and had hit a point where I could FIRE more than two years ago but kept pushing due to my own insecurity. But hey, more on that next time! This PTSD series is really dragging on, isn’t it? So it goes. Hope to see you for the next installment.
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