PTSD Evaluation Specialist (DSM-5)

Initial PTSD DBQ DSM-* Name: Timothy “Brian” Baker (10/11/85)

Page 1 of 14 For Use By: University of MO Veterans Law Clinic Initial Post Traumatic Stress Disorder (PTSD) – DSM V Disability Benefits Questionnaire

(Based on VA Form/DBQ of DSM-5)

FIRST NAME, LAST NAME, MIDDLE NAME (SUFFIX): SOCIAL SECURITY NUMBER/FILE NUMBER:

TODAY’S DATE:

Timothy “Brian” Baker 9035 25NOV2025

HOME ADDRESS: EXAMINING LOCATION AND ADDRESS:

687 SW 11th Road, Warrensburg, MO 64093

Telemed via Doxy.me

HOME TELEPHONE:

660-***-****

Examiner License Univ. of MO Veterans Law Clinic

Amy B. Beebe, Ph.D. TNP1666/NPI: 192******* Carter Brooks Templeton, Esq. This evaluation is based on DSM-5 diagnostic criteria. NOTE: This DBQ is being completed via Telemed/Doxy.me and does not constitute a therapeutic relationship. It is solely for the purposes of exam only and explained to the veteran at onset. Examiner is a VA qualified examiner and no supervision of any type was utilized as was wholly performed and written by Dr. Amy B. Beebe, Ph.D., licensed psychologist. The veteran was not charged a fee and no remuneration from veteran is expected. The examiner is a consult for the University of Missouri and paid for time, not opinion, as is consistent with other types of contract examiners the VA utilizes. SECTION I - DIAGNOSTIC SUMMARY

1. DIAGNOSTIC SUMMARY

This section should be completed based on the current examination and clinical findings. Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria based on today’s evaluation? X Yes No

ICD code: F43.10

If no diagnosis of PTSD, check all that apply:

Veteran’s symptoms do not meet the diagnostic criteria for PTSD under DSM-5 criteria

Veteran does not have a mental disorder that conforms with DSM-5 criteria 2. CURRENT DIAGNOSES

2A. Mental Disorder Diagnosis #1: PTSD

ICD code: F43.10

Comments, if any: symptoms present with some waxing and waning over the years and symptom masking at times due to substance use/abuse.

Mental Disorder Diagnosis #2: Unspecified Bipolar and Related Disorder ICD code: F31.9

Comments, if any: began in service and has continued to date, albeit with waxing and waning and symptom masking at times due to substance use/abuse.

Mental Disorder Diagnosis #3: Stimulant (amphetamine-type/Meth) Use Disorder, in remission ICD code: F15.21

Comments, if any: likely secondary to the Bipolar and PTSD as maladaptive form of self-medication. Initial PTSD DBQ DSM-5 Name: Timothy “Brian” Baker (10/11/85) Page 2 of 14 For Use By: University of MO Veterans Law Clinic 2B. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): residuals of left ankle injury

ICD code: Defer to Medical

Comments, if any: pain triggers intrusive memories at times and increases irritability and avoidance, mild 3. DIFFERENTIATION OF SYMPTOMS

3A. Does the Veteran have more than one mental disorder diagnosed? X Yes No (If “Yes,” complete Item 3B) 3B. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? X Yes and X No Not applicable

Yes: as the Stimulant (meth) Use Disorder is in remission, there are currently no contributing symptoms from the SUD.

NO: PTSD & Bipolar: There is symptom overlap with reciprocal aggravation. Although some symptoms can be distinguished in therapy, for diagnostic purposes (i.e. symptoms as defined by DSM-5 criteria), conditions and components interact, exacerbate and reinforce each other in complex ways, and it is not possible to distinguish the portion of each symptom-- uniquely due to each condition-- without making an artificial distinction or resorting to mere speculation. Discuss whether there is any clinical association between these diagnoses: The stimulant use disorder was likely secondary to the PTSD/Bipolar as maladaptive form of self medication. It is also likely that the stress of service, including service in DIDPA/Combat Zone with significant exposure to trauma/stressor(s) triggered the Bipolar. Regardless of etiology, there is symptoms overlap w/ reciprocal aggravation such that artificially parsing out specific symptoms and assigning to specific diagnosis is not possible w/o resorting to mere speculation. 3C. Does the Veteran have a diagnosed traumatic brain injury (TBI)? Yes No X Not shown in records reviewed 3D. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? Yes No X Not applicable 4. OCCUPATIONAL AND SOCIAL IMPAIRMENT

4A. Which of the following best summarizes the Veteran’s level of occupational and social impairment with regards to all mental diagnoses? (Check only one)

No mental disorder diagnosis

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 medication

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 medication

Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation

Occupational and social impairment with reduced reliability and productivity X Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood

Total occupational and social impairment

4B. For the indicated level of occupational and social impairment, is it possible to differentiate which impairment is caused by each mental disorder? X Yes X No Not applicable

Yes: As the SUD is in remission, no contribution to the occupational/social impairment. NO: PTSD/Bipolar: Conditions and components interact, exacerbate and reinforce each other in complex ways and it is not possible to separate the portion of impairment uniquely due to each condition without making an artificial distinction or resorting to mere speculation. 4C. If a diagnosis of TBI exists, is it possible to differentiate which occupational and social impairment indicated above is caused by the TBI? Yes No X Not applicable

Initial PTSD DBQ DSM-5 Name: Timothy “Brian” Baker (10/11/85) Page 3 of 14 For Use By: University of MO Veterans Law Clinic SECTION II - CLINICAL FINDINGS

1. EVIDENCE REVIEW

In order to provide an accurate medical opinion, the Veteran’s claims folder must be reviewed. Evidence reviewed (check all that apply):

Not requested

VA claims file (hard copy paper C-file)

VA e-folder

CPRS

X Other (please identify other evidence reviewed):

No records were reviewed

The records provided by the University of Missouri (MIZZOU) including c-file, Capri, military records, filings, decisions, VA tx records, etc. were reviewed for relevancy, including but not limited to those cited below. Evidence Comments:

Other SC Conditions Found: residuals, left ankle injury; 26NOV19, Information Report~ USMC, CPL (E4), Honorable, 11/8/05 to 11/7/09, Reserves 11/8/09 to 7/10/13, CPL, Honorable…Hostile Fire/IDP w/ Combat Zone Tax Exclusion 2/1/07-6/30/07, Location: ZZ, Hazardous Duty Incentive Pay 4/1/07 to 6/30/07…

DD214~ USMC-11, E4, Honorable, 11/8/05 to 11/7/09, Aviation Maintenance Admin Spec., MC GCM, SSDR, GWOTEM (Iraq), GWOTSM (2), NDSM, Letter of Appreciation, Certificate of Commendation, Rifle Sharpshooter Badge…

30SEP09, Separation Exam~ silent for mh and related endorsements… 23SEP09, STR, FB Martenis, PCC, NHC Cherry Point~ Bipolar Disorder, manic w/ psychotic features…The OQ-45 score was 27 indicating very mild psychological discomfort, job and/or interpersonal relational issues. ~ MENTAL STATUS EVALUATION: Duration: 60 min. Cpl Baker was neatly groomed and appropriately dressed, alert, and oriented. He described his mood as "calm and happy". His affect matched his self description. He spoke easily and did not appear to have any problem with concentration or memory. He spoke spontaneously and made appropriate eye contact. He showed moderate psychomotor restlessness. Thought processes and speech were logical, linear, and goal directed, and there was no evidence of psychosis, delusion, or organicity. Social judgment and impulse control appeared intact. The patient denied SI/HI and continued his contract credibly for safety. ONGOING NOTES: stated that he gets angry at times and believes he needs assistance with his anger. Although his mood has stabilized, it is my opinion that he should remain on limited duty and be observed. 22SEP09, STR, Department of Psychiatry, BD Smullen, MD, US Naval Hospital Camp Lejeune~ Substance Induced

(caffeine) Mood Disorder-Mania (provisional), Partner Relational Problem, rx Olanzapine… Admit 9/15/09, Discharge: 9/22/09…In brief the patient reported at least four days of significant insomnia, euphoria and preoccupation with health concerns that may have somehow been the result of malfeasance at his command or due to unspecified others, e.g. he appeared very concerned that he might have been infected with the HIV virus. During the mental health evaluation thoughts were noted to be tangential and disorganized and possibly delusional and he appeared to be mildly agitated. He had very recently been seen for a c/o ;anxiety and depression which he ascribed to the stresses of marital separation and upcoming release from active duty. He had been placed on Sertraline and Ambien, neither of which he Was strictly compliant with. He had also recently begun taking Bupropion for smoking cessation. He was referred for direct admission for further evaluation and treatment. 21SEP09, STR, BD Smullen, SF 505~ Impression: r/o Bipolar I, MRE Manix, r/o Substance Induced mood d/o, r/o psychosis…GAF=25-30.

11JUL05, Enlistment Exam~ (19 y/o//67.25”/179#)…silent for mh and related…acknowledged hx of marijuana use but no other…

10JUL24, MH Note/KC-BH VJO, AM Nogan, KC VAMC~ Did you serve in a theatre of operations for any military conflict? Yes; HMM 264…When he graduates, he would have 1 year probation for Linn County and none for Johnson. If he wasn't in Recovery Court, he could face 7 years for Linn charge and 5 for Johnson. No violent charges…MENTAL HEALTH Have you ever been diagnosed with a mental health condition? Yes, Veteran reported being diagnoses with Bipolar and PTSD. Veteran shared that his job, workload and responsibility was very stressful in the military, constant and he reported taking on others' work, worked days and nights, covering others shifts/jobs. Veteran reported "I was overworked and my marriage and mental well being suffered." Veteran described when he actually got time off, "the military thing to do was drink and that was my coping and that eventually led to other things down the road." Veteran reported an incident when deployed, doing patrols in Jordan, where CO got in his aircraft and bombed their unit, not the target. Veteran reported this was life-changing and couldn't sleep, plus all the other stress, and he ended up "with a nervous breakdown about a month later." Veteran reported that others shunned him and told not to contact him, his wife had left him during deployment and it was horrible. During "nervous breakdown" he was flown to Cherry Point Hospital and Camp Lejeune MH ward. Veteran reported his mother was flown out to assist with his base housing, but overall this was all traumatizing, isolating, and life changing, negative direction to his course. Veteran reported mood Initial PTSD DBQ DSM-5 Name: Timothy “Brian” Baker (10/11/85) Page 4 of 14 For Use By: University of MO Veterans Law Clinic stabilizer is currently at a good dose. Veteran reported he is doing okay, no SI/HI. No history of attempts. Negative Colombia. Have you ever been hospitalized for a mental health condition? Yes… 08JUL24, MH/KC-BH VJO Progress Note, AM Hogan, KC VAMC~ Primary Diagnosis: Legal, Secondary, SUD, Bipolar, Trauma…Veteran is currently living with his mother but has a significant history of being homeless in his past. Veteran reported that his mother's house is safe but it would be best for him to have his own place. Veteran is working approx 36 hours per week now, but his wages are being garnished from child support. Veteran reported that he might be interested in being screening for HUD VASH at some point, but feels that he might be more interested in speaking with SSVF provider.

12OCT22, MH Domiciliary Note, TM Maraldo, Columbia MO VAMC~ Stimulant UD, amphetamine-type, severe (Meth), AUD in remission…admitted for treatment of stimulant use disorder, amphetamine-type substance, severe…numerous probation violations d/t ongoing methamphetamine use and could face up to 12 years in prison if probation revoked…2gs of IV meth a day for past 4 months, but struggles w/ meth for past 20 years…diagnostic profile is very unclear d/t combination of tx noncompliance and ongoing substance use, reports diagnoses of Bipolar and PTSD…does not have clear history of mania or hypomania sxs that would warrant Bipolar d/o dx…hx of traumatic military event but did not report additional intrusive, avoidance, mood/cognition or arousal sxs…hx of psychotic disorder related to substance-induced type…Uncle cooked meth and started using at about 15 years of age, sobriety in USMC and prison…Denied any history of childhood physical, sexual, emotional or verbal abuse/neglect…Mr. Baker served in the USMC from 2006-2010. His highest rank and rank at discharge was E-4. He reported working in air command. He stated that he was deployed on a meu [Marine E-vac Unit] for a period of time as well as to Afghanistan

[sic/Iraq]. While he denied being engaged in active combat, he did report being on patrol. Additionally, he reported that his C.O. accidentally bombed their own unit during a training exercise, which resulted in 30 casualties. Veteran reported that he was a first responder to the bomb incident, which was traumatic. He denied any history of MST. Veteran denied any history of disciplinary action and reported receiving an honorable discharge… Buddy/Lay Statements:

11DEC19, Buddy/Lay Statement, Mother: Kimberly Linville~ fully read and appreciated…highlights: anger problems ever since came home from Marine’s in 2009…attacked little brother after brother playfully hit mom in breast, gave brother bloody nose…violent outbursts, walking on eggshells, never know what will set him off…tried to get shot gun out after found out gf lied about pregnant…like flipping a switch, struggles to keep jobs, relationships and maintain residence, turned to drugs to mask everything…hospitalized at Camp Lejeune, went w/ bf and stayed w/ after released from hospital, thought tv was talking to him and the radio too…joined Marine’s happy, newly married man and came out broken man facing divorce…depression, anger, anxiety, sleeplessness and introverted… 11DEC19, Buddy/Lay Statement, Dana Ridge~ fully read and appreciated…highlights: 3 year relationship, got mentally and physically and emotionally abusive, black eyes, broken nose, kicking dog, kept from her daughter in an argument by choking her…

23SEP19, Buddy/Lay Statement, Gary Arnold~ 2016 act of violence, from neutral to yelling, pushing, pounding in chest…

Previous Exam(s)/Rating Decision(s):

21JAN25, Rating Decision~ SC for bipolar disorder is denied. Evidence shows that we requested a VA medical examination and opinion for you. The VA examination dated October 9, 2024, does not show a current diagnosed disability for bipolar disorder. (38 CFR 3.159, 38 CFR 3.303) The examiner stated the following: In today's review of records there is not a clear history of bipolar illness in the military. Records from 2009 are mixed regarding the diagnosis of bipolar disorder vs. other disorders such as substance induced psychosis, depression, and anxiety. Also there is the Veteran's own account of extreme stress related to the loss of his marriage, sleep deprivation, and extreme alcohol abuse around the time of his 2009 hospitalization. Also, there is not a clear history of bipolar disorder post- military. At least two evaluators (Bisel, 2015 and Maraldo, 2022) noted a past diagnosis of bipolar disorder, but did not continue that diagnosis in their own assessment. Post military he has had numerous symptoms such as anxiety and depression, but no evidence of a manic or hypomanic episode. His post-military mental health symptoms of depression and anxiety are in the context of a longstanding stimulant use disorder and his records do not provide a clear nexus between his military and post-military symptom presentation. He does have a clear and consistent history of Stimulant Use Disorder, Amphetamine-Type which by his account began post-military. It is in the context of this stimulant use disorder that he has presented with various mental health symptoms, and these symptoms cannot be reliably disambiguated from the context of his stimulant use disorder. The claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. We did not find a link between your medical condition and military service. (38 CFR 3.303)… Favorable Findings identified in this decision: The evidence shows that a qualifying event, injury, or disease had its onset during your service. Your service treatment records show you were treated for bipolar disorder on September 15, 2009. You have been diagnosed with a disability. The VA examination dated October 9, 2024, provides a diagnosis of Stimulant Use Disorder, Amphetamine-Type, Severe. Evidence shows that you performed service in the Red Sea via USS Bataan in 2007. You were exposed to burn pits and particulate matter during military service.

Initial PTSD DBQ DSM-5 Name: Timothy “Brian” Baker (10/11/85) Page 5 of 14 For Use By: University of MO Veterans Law Clinic 09OCT24, Mental Disorders DBQ w/ MO, KJ Kobes, contract examq~ F15.20, Stimulant Use Disorder, Amphetamine- Type, Severe, o/s w/ reduced reliability/productivity…MO: negative opinion… The claimed condition is less likely than not (likelihood is less than approximately balanced or nearly equal) incurred in or caused by the claimed in-service injury, event, or illness. Rationale is: The Veteran is diagnosed today with Stimulant Use Disorder, Amphetamine-Type, Severe based on today's DBQ evaluation. His entrance record in 2005 does not show problems with psychiatric and neurologic issues. A 12/4/2006 report of medical history PHA does not show any mental health symptoms. In 2009 there is evidence of STR's of a mental breakdown and hospitalization. Various diagnoses are given, including Bipolar I disorder, anxiety, depression, moderate recurrent major depression, axis 1 deferred, mixed/unspecified drug abuse unspecified use, and drug induced mood disorder. A 9/15/2009 record by Leif Crowe suggests a mental impairment, similar to a manic episode, possibly triggered by the administration of Zoloft. A September 2009 Discharge Medication Worksheet indicates he was on Zyprexa with the intent to stay on Zyprexa. A separation report of medical history does not show any mental health symptoms endorsed. A separation Report of Medical Assessment shows he was under the care of a neuropsychiatrist, was doing well, with no current concerns, but should have continued counseling post- military. The Veteran reported in today's DBQ that at the time of his 2009 mental breakdown he was depressed over his marriage failing, he had the mentality/maturity of a 10 year old, he was exhausted from working extreme hours (16 hour days), and he was involved in extremely heavy drinking. He denied drug use other than alcohol until postmilitary, although the September 2009 record of inpatient treatment gave him the diagnosis of mixed/unspecified drug use and drug-induced mood disorder, as well as family disruption. A 12/18/2015 Psychiatry note by Kelly Bisel notes a history of bipolar mood disorder diagnosis, and a referral for anxiety, irritability, and stress. She chronicled his history of his 2009 breakdown related to feeling overwhelmed and not sleeping due to work duties, anxiety, depression. Her DSMV diagnosis shows MDD and unspecified anxiety disorder, but does not show bipolar disorder. It notes the need to rule out a mood disorder, PTSD, and intermittent explosive disorder. A 10/12/2022 Mental Health evaluation by Toni Marie Maraldo shows an admission to 2C-PRRTP for treatment of stimulant use disorder, amphetamine-type substance, severe. Dr. Maraldo chronicled the Veteran's history, including a review of bipolar disorder symptoms. She noted that when asked about history of mania he was only able to identify anger, aggression, and violence as his primary symptoms. She noted that these were presented as chronic symptoms, not symptoms that would occur in a discrete episode such as bipolar disorder. She concluded that the Veteran does not have a clear history of mania or hypomania sufficient to warrant a bipolar diagnosis. She also noted that many of his symptoms occurred in the context of a stimulant use disorder. She diagnosed him with stimulant use disorder, amphetamine-type substance, severe. In today's review of records there is not a clear history of bipolar illness in the military. Records from 2009 are mixed regarding the diagnosis of bipolar disorder vs. other disorders such as substance induced psychosis, depression, and anxiety. Also there is the Veteran's own account of extreme stress related to the loss of his marriage, sleep deprivation, and extreme alcohol abuse around the time of his 2009 hospitalization. Also, there is not a clear history of bipolar disorder post-military. At least two evaluators (Bisel, 2015 and Maraldo, 2022) noted a past diagnosis of bipolar disorder, but did not continue that diagnosis in their own assessment. Post military he has had numerous symptoms such as anxiety and depression, but no evidence of a manic or hypomanic episode. His post-military mental health symptoms of depression and anxiety are in the context of a longstanding stimulant use disorder and his records do not provide a clear nexus between his military and post-military symptom presentation. He does have a clear and consistent history of Stimulant Use Disorder, Amphetamine-Type which by his account began post-military. It is in the context of this stimulant use disorder that he has presented with various mental health symptoms, and these symptoms cannot be reliably disambiguated from the context of his stimulant use disorder. THE CLAIMED CONDITION WAS LESS LIKELY THAN NOT (LIKELIHOOD IS LESS THAN APPROXIMATELY BALANCED OR NEARLY EQUAL) INCURRED IN OR CAUSED BY THE CLAIMED IN-SERVICE INJURY, EVENT, OR ILLNESS. 27FEB20, Rating Decision~ The previous denial of SC for PTSD is confirmed and continued. On December 6, 2019 and January 17, 2020 we asked you for specific details of the stressful incident(s) in service that resulted in post traumatic stress disorder (PTSD). To date no response has been received. A claimant may file a supplemental claim by submitting or identifying new and relevant evidence. New evidence is evidence not previously part of the actual record before agency adjudicators. Relevant evidence means evidence that tends to prove or disprove a matter at issue in a claim. (38 CFR 3.2501) In support of your claim, new and relevant evidence has been received and your claim is now reconsidered. Favorable Findings identified in this decision: Your VAMC records note treatment for PTSD. 30OCT15, Rating Decision~ SC for PTSD is denied. The available medical evidence is insufficient to confirm a link between current symptoms and an in-service stressor. You claimed service connection for PTSD due to fear of hostile military or terrorist activity. However, available evidence of record to include the Marine Corps Personnel records, the DD Form 214 and the service treatment records fail to show that you were stationed in an area of combat activity whereby you would have experience one of the above incidents. On the Post-Deployment Health Assessment, you indicated that during your period of deployment you were aboard ship. On this form, you checked "no" when asked if you had seen anyone wounded, killed or dead during this deployment; if you were engaged in direct combat where you discharged your weapon; if you ever felt that you were in great danger of being killed: and if you were interested in receiving help for a stress, emotional, alcohol or family problem. The DD 214 shows sea service of 7 months but no foreign service.

Initial PTSD DBQ DSM-5 Name: Timothy “Brian” Baker (10/11/85) Page 6 of 14 For Use By: University of MO Veterans Law Clinic 2. HISTORY

NOTE: Initial examinations require pre-military, military, and post-military history. If this is a review examination, only indicate any relevant history since prior exam.

2A. Relevant social/marital/family history (pre-military, military, and post-military): The veteran’s last exam was in October of 2024, please see for history prior, though relevant will be reviewed where applicable.

He has his own place now and has had stable housing for the past 10 months. He uses his mother’s address for important mail and can default to her if his housing becomes unstable. He does not currently identify as homeless but has had periods of housing insecurity. He was initially helped with finding housing via Catholic Charities and has been independent in maintaining housing for the last 4 of the 10 months.

He has contact with his son, who is now 9, and gets him every other weekend for parenting time with the veteran. He was married to the mother just before he joined and divorced while in service and after his deployment. He is not in a relationship and has not dated in about 8 months. He has trust issues, doesn’t like being with people and doesn’t like going out, all of which have been detrimental to his social life/dating, etc. He will play X-box and his guitar as hobbies as he really enjoys music. Going to listen to music is a comfort but he has to be in small venue or outdoors as he can’t tolerate groups of people. He will not go into establishments if they look too crowded and will leave if gets overwhelmed by the number of people. He will leave his potential purchases and flee when gets overwhelmed.

He is most social with his younger brother. He has co-workers he considers “friends” but no interaction outside of work. His brother is his identified best friend. He will take his son swimming as his mom has a heated pool and they go to the community center as well. He stated others note his temper is short and “things just happen out of my control”. He will get angry and say things he shouldn’t and can get violent as well if the verbal doesn’t’ work, I escalate quickly”. He has never been violent with his son or women in general, “not usually, it’s a man thing”. He can be quite intense, vitriolic and verbally aggressive. His sleep is disrupted and “sporadic”. He may get 4-6 hours of sleep at the time. He struggles to get to sleep due to racing thoughts and then wakes frequently. Nightmares and noises wake him multiple times and will have to get up and check the house. “I can’t go into a deep sleep and stay. He has black-out curtains throughout the apartment to help with sleep. He is loud and restless in his sleep and described an aggressive startle on waking if touched. He has had episodes of sleep fighting and sometimes wakes feeling “beat to hell”. He will have an episode every few weeks where he doesn’t sleep at all. As described, its an exhaustive “can’t sleep, I’m so tired” rather than a manic where he doesn’t feel he needs to sleep and is doing other things. He could not recall the last time he awoke feeling refreshed.

2B. Relevant occupational and educational history (pre-military, military, and post-military): Pre- nothing to add

During: DD214~ USMC-11, E4, Honorable, 11/8/05 to 11/7/09, Aviation Maintenance Admin Spec., MC GCM, SSDR, GWOTEM (Iraq), GWOTSM (2), NDSM, Letter of Appreciation, Certificate of Commendation, Rifle Sharpshooter Badge…

Information Report~ USMC, CPL (E4), Honorable, 11/8/05 to 11/7/09, Reserves 11/8/09 to 7/10/13, CPL, Honorable…Hostile Fire/IDP w/ Combat Zone Tax Exclusion 2/1/07-6/30/07, Location: ZZ, Hazardous Duty Incentive Pay 4/1/07 to 6/30/07…

Post: The veteran is currently employed at Dollar Tree Distribution Center and has been for about a year. He works swing shift which is 2:30p-Midnight, M-F. Prior to that he struggled with working b/c Initial PTSD DBQ DSM-5 Name: Timothy “Brian” Baker (10/11/85) Page 7 of 14 For Use By: University of MO Veterans Law Clinic of his drug addiction and negative encounters with law enforcement. He has struggled at work w/ his verbal outbursts and has been sent home b/c he snapped his safety glasses in two in a fit of rage when the pallet fell over.

2C. Relevant mental health history, to include prescribed medications and family mental health (pre-military, military, and post- military):

Pre: nothing to add

During: Veteran was seen by military mental health providers beginning in late 2009 and after his exposure to the stresses/traumas of being in a hostile fire/combat zone (Feb-June 2007). He started using stimulants while still in service to cope and was initially diagnosed with a r/o of Bipolar I and r/o of substance induced mood d/o w/ a r/o of psychosis as well. He was psychiatrically hospitalized in September of 2009 and eventually diagnosed w/ Bipolar Disorder, manic with psychotic features.

Post: The veteran has continued to struggle with self medication with stimulants and has been in and out of rehab facilities. His stimulant use disorder (methamphetamine) was paramount during those treatments as was causing the most disruption to his functioning. He also has treating

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