Ryan H.

§ 3.655 Failure to report for Department of Veterans Affairs examination. (a) General. When entitlement or continued entitlement to a benefit cannot be established or confirmed without a current VA examination or reexamination and a claimant, without good cause, fails to report for such examination, or reexamination, action shall be taken in accordance with paragraph (b) or © of this section as appropriate. Examples of good cause include, but are not limited to, the illness or hospitalization of the claimant, death of an immediate family member, etc. For purposes of this section, the terms examination and reexamination include periods of hospital observation when required by VA. (b) Original or reopened claim, or claim for increase. When a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record. When the examination was scheduled in conjunction with any other original claim, a reopened claim for a benefit which was previously disallowed, or a claim for increase, the claim shall be denied. © Running award. (1) When a claimant fails to report for a reexamination and the issue is continuing entitlement, VA shall issue a pretermination notice advising the payee that payment for the disability or disabilities for which the reexamination was scheduled will be discontinued or, if a minimum evaluation is established in part 4 of this title or there is an evaluation protected under § 3.951(b) of this part, reduced to the lower evaluation. Such notice shall also include the prospective date of discontinuance or reduction, the reason therefor and a statement of the claimant's procedural and appellate rights. The claimant shall be allowed 60 days to indicate his or her willingness to report for a reexamination or to present evidence that payment for the disability or disabilities for which the reexamination was scheduled should not be discontinued or reduced. (2) If there is no response within 60 days, or if the evidence submitted does not establish continued entitlement, payment for such disability or disabilities shall be discontinued or reduced as of the date indicated in the pretermination notice or the date of last payment, whichever is later. (3) If notice is received that the claimant is willing to report for a reexamination before payment has been discontinued or reduced, action to adjust payment shall be deferred. The reexamination shall be rescheduled and the claimant notified that failure to report for the rescheduled examination shall be cause for immediate discontinuance or reduction of payment. When a claimant fails to report for such rescheduled examination, payment shall be reduced or discontinued as of the date of last payment and shall not be further adjusted until a VA examination has been conducted and the report reviewed.

Thank you. I have only been here in Virginia since last July. I have contacted the local VA med center. I have to Register here, and be assigned a primary care DR before getting an appointment with a mental health dr. I am not opposed to treatment, just am not very fond of the group meetings. I have actually been regressing a bit in the last few months. It's been a roller coaster ride for sure. I'm more reclusive, and substantially more quick tempered. The position I have now for work is probably the best situation I could be in. I am left alone to do my job, and am respected for my results. Luckily, I don't have to interact with many people, and have a very regimented schedule. I do not want UI, or even to be rated higher than my current rating. I am a 100% supporter of the ratings system if done properly and fairly. If i am evaluated and the evidence supports a reduction then I will accept it and continue on. From everything I have read, and researched in the last 24hrs, this is my fault, and as long as I allow the VA system to treat me then I SHOULD not have any further issues. The regs say that if I present myself as available for an exam and go to the exam then the rating will be based on federal regulations in place protecting me from an unwarranted decrease. I was in a bit of a panic last night. The thought of going through the system again is daunting, and it brings up the feelings I try to keep down, with ease. In summary, I have done all that I can at the moment. The DAV rep @ the Pittsburgh RO will go there Tuesday and attempt to put a hold on the decrease and request a C&P exam. If they follow through with a decision, I can request a hearing within 30 days, and express that I am available and willing to be examined. The regs say that they have to accept this and schedule the exam. If, at that point, I do not show to the exam then the decided rating is enforced, and I will have to request an increase. Basically, it's all on me. I put myself in this situation, and I have to do what the VA wants to get out of it.

70% Ptsd is what they are reducing. Originally Service connected in 05 increased in 08.

Hi all.... this place saved me once, maybe again. I was rated in March of 2008, over 6 years ago. I have not been back to the VA since my rating. The time spend dealing with the claim process was one of the hardest times in my life. Since my rating, I have been fired twice, laid-off twice, divorced twice, had a child, remarried a third time, and have had 6 different jobs. The mother of my child does not let me have a relationship with her because of the issues I have. My problems are not better, I am not better. I have moved at least 10 different times. I have changed VA regional offices at least 4 times, and have lived over seas on two separate occasions for work. The VA tried to examine me for an increase in 2010, but due to me being overseas, and moving so often it was impossible to schedule the exam. In Jan of 2012 I was notified that the claim was closed, no changes were made. Today I go on ebenifits to check the status of the dependent adjustment I made in 2012, and found out that a claim type "predetermination" with the contentions of "Due Process/propose to reduce for PTSD (New)" was open on 25 Jan 2012, the day after my last claim was closed. I was NEVER notified of this claim being opened. I was NEVER scheduled for an appointment. It was NEVER requested of me to provide documentation on equip. The status of this claim is currently "Pending Decision Approval". Upon noticing the claim I called the VA and requested the information on what exactly this is. I was told it is not a "claim" it is a predetermination stating they will be reducing my my rating due to the fact they could not adequately contact me. Since the 2012 claim was initiated, I purchased a home using a VA loan, I also opened a dependent claim with the same VARO. NOT one single time did they notify me or request me attend a C&P exam. I promptly requested the VA lady help with this and clear the matter up prior to the Decision Approval, and then requested the file be transferred to the RO of the State I am currently living and not the International RO. She gladly did this, and was VERY helpful, but she also said that nothing is guaranteed. If a decision is made prior to the new info being reviewed there will be nothing I can do other than request a hearing. I also immediately called the DAV and requested the personally visit the office and ensure that I am more than willing to go to a C&P exam, and for them to schedule it immediately. I realize the correct action is to go to therapy, go to meetings, but when there are people counting on my income for support, and I have to continually move from contract to contract to provide this income, the VA becomes a last priority. As most everyone holding down a schedule, a job, a live, a relationship with PTSD is hard enough. I cope, and deal the best ways I can. It has nearly cost me my life more than once, but it has provided for a better life for the ones who count on me. Being expected to go into meetings to talk about life enrages me. I cannot do it, and being expected to go is intolerable for me. SO WHY DOES THE VA INSIST ON MAKING IT EVEN HARDER BY REDUCING A STABLE RATING????? This is speculative. The decision has not been made, and this could be all for not, but it has me scared that my life and family will now suffer more at the hands of these people. Now my questions are: 1) How can they legally reduce the rating after 5 years without an examination disclosing an improvement. The federal code (see below) is clear on this, and no examination has been completed. 2) How can they legally reduce a rating without due process of notification? 3) Can a "predetermination" type claim be withdrawn prior to decision approval? 4) What is the opinion of the members here when it comes to fighting this during a hearing if the VA decides to follow through with the reduction? Do I have a leg to stand on???? §3.344 Stabilization of disability eval- uations. (a) Examination reports indicating im-provement. Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of dis- ability evaluations consistent with the laws and Department of Veterans Af- fairs regulations governing disability compensation and pension. It is essential that the entire record of examina- tions and the medical-industrial his- tory be reviewed to ascertain whether the recent examination is full and com- plete, including all special examina- tions indicated as a result of general examination and the entire case his- tory. This applies to treatment of intercurrent diseases and exacer- bations, including hospital reports, bedside examinations, examinations by designated physicians, and examina- tions in the absence of, or without tak- ing full advantage of, laboratory facili- ties and the cooperation of specialists in related lines. Examinations less full and complete than those on which pay- ments were authorized or continued will not be used as a basis of reduction. Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psy- chotic reaction, epilepsy, psycho- neurotic reaction, arteriosclerotic heart disease, bronchial asthma, gas- tric or duodenal ulcer, many skin dis-eases, etc., will not be reduced on any one examination, except in those in- stances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest. Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life. When syphilis of the central nervous system or alcoholic deterioration is diagnosed following a long prior history of psychosis, psychoneurosis, epilepsy, or the like, it is rarely possible to exclude persistence, in masked form, of the preceding innocently acquired manifestations. Rating boards encountering a change of diagnosis will exercise caution in the determination as to whether a change in diagnosis rep- resents no more than a progression of an earlier diagnosis, an error in prior diagnosis or possibly a disease entity independent of the service-connected disability. When the new diagnosis reflects mental deficiency or personality disorder only, the possibility of only temporary remission of a superimposed psychiatric disease will be borne in mind. (b) Doubtful cases. If doubt remains, after according due consideration to all the evidence developed by the several items discussed in paragraph (a) of this section, the rating agency will con- tinue the rating in effect, citing the former diagnosis with the new diag- nosis in parentheses, and following the appropriate code there will be added the reference ‘‘Rating continued pend- ing reexamination lll months from this date, §3.344.’’ The rating agency will determine on the basis of the facts in each individual case whether 18, 24 or 30 months will be allowed to elapse before the reexamination will be made. © Disabilities which are likely to improve. The provisions of paragraphs (a) and (b) of this section apply to ratings which have continued for long periods at the same level (5 years or more). They do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating.

Thanks for all the input. I sent the form in today and hopefully I will know something by the end of next month. I am leaving my job in 6 weeks. I only stayed this long because it was this or the streets. I doubt that there is any way for this to go through before fall semester starts so I might as well just bank on what i have for now. I did not get a TDUI form with the rest of the info they sent. I am corting the idea of moving back to florida to be closer to some family but i dont know if i could handle that as of right now. Thanks again!

I would have no issues with the Va reducing me if they helped to put me in a job that would make my everyday life more enjoyable. I mean, right now life sucks. I have no motivation, or desire to do anything. When I'm not working I sit on the couch and sleep or numb my brain with music. I think that if I enjoyed what i did every day and if I had some one behind me to help me do it then I would better off in the long run. I'm 25. Some days i cant bear to think about what the rest of my life would be like if nothing changed. The pills help but when its bad then its bad and the only thing that makes it better is to know that there is the smallest possibility that things can only get better. To be honest the VA has done its job for me. They treat me for my issues, and the compensate me adiquitly. I realize that I am a lucky one, I am one of the few that the system has worked for. I hate that there are vets here that have had to wait years when I only had to wait 3 months. Thats 3 months start to finish. I it would have been much longer if not for the vets here giving me the advise i needed to straighten out the claim before it got to the rater. Wow i went off on a wild ride just then. I guess what I'm saying is I feel that there are many vets that are worse than me and have been dealing with these problems alot longer. If voc rehab helps me get to a point in my life where I felt comfortable then that would be worth every penny the va decided to take back.

I got the envelope that wet with what the 1800 number told me. I got a 80% combined rating. I do not want TDUI or whatever it is. I want a career that I enjoy that can maybe reduce my mental problems and improve my quality of life. I have filled out the Voc rehab form and I think I'm supposed to send it to the RO. I have some questions about the process. 1) After i submit the form is it a lengthy process to get the first apointment? 2) How does the process work? 3) Can I pic what I know I want to do. Here is what I'm wanting from this. In the Marines I flew in Helicopters as a crew chief. Helicopter still make me a bit jumpy, but i associate some of my best and worse memories with flying while in the states. (Iraq is a different story). I want to fly helo's for a living, I want to work for a company that maybe does tours or arial photagraphy. There is a good state college here that offers a professional aviation degree and I think it would be best for me to go there. I would already have half of the required credits done due to me having an A&P license. 4) If i go through the Voc Rehab process does that require me to do what they feel is best or do I have input in the degree I want to do? 5) Will i get the GI bill while also having Voc rehab pay the tuition and books? 6) Would i lose my rating if I were to graduate and gain employment. Honestly I would not care to lose the rating as long as my job helped me mentally feel better about myself. Any input would be nice and thanks agian for all the help!

Retro is not quite right.... bout a thou difference. I am not going to fight that battle. Too tired from this one.

OMFG the VA actually got something right for once. I have alot to say about this. As a young vet i have been reading the posts from some of the older people on here. I kept my mouth shut because honestly I didnt know what to think. I have to say that I agree with them. The VA rated me correctly the first time. I am now 80% total. I am 10% tennitus, 20% ankle arthritus, and 70% PTSD. They rated me at 0% for Acid Reflux. This is exactly what I expected and what I wanted. I am going to file an NOD for the reflux after My Dr apt on friday but they were spot on for all the other ratings. I have to give props to the Nashville RO for them being very informative, and very fast on my claim. I also have to give the most credit to you! The readers and the people that took the time to help me with my questions and gave me all the info I needed to make sure the VA system worked the way it was supposed to. Rentalguy- You were the first one to help me here. You advise from day one was what got my claim right the first time. I truely hope the Nashville RO treats you as well as they have treated me. Thank you. If i'm back in the Tricities area dinner is on me for sure. Berta- WOW! I cannot tell you how much i enjoy reading your posts. You do more research than the people that get paid to do it. You are a god send to all the people on this site and we are very lucky to have a wonderful woman like you to help all of us lost vets out. Testvet- you kept me motivated and active thank you for your time. Thanks to all once again!

I just got the VA deposit!!!!! I have to call the 1800 number to see what they rated me at... Looks like maybe around 60 or 70%.... Right where I feel I should be at.... I'll let you guys know more later!

YEAH!!!!! Berta's advice was spot on. I mean i dont think it could have been any better. I do not have total impairment due to my MH but in the areas questioned i am impaired. I am not fighting this to be 100% Disabled, actually i would be happy with 70% with all my ratings combined. I want to work, I want to have a carreer to be proud of, but I also believe that unless I get Voc rehab that will not happen. I can not get that unless i get a higher rating. I am young and I understand that many on this site are far worse off than me, I also know that my battle has not bee half as hard (so far) as most other Vet's on this site. I have the utmost respect for YOU people that take the time out of YOUR day to help a complete stranger. There are not many people left in this world that would do that. Most people look at Vets fighting for compensation as money hungary and trying to take advantage of the system. I felt that way untill i saw the same problems happening to vets all over the US happening to me. that is a very humbling expierence. The following is what was on the last part of the C&P exam write up. I think this is what you are asking for...... Does each criteria of mental disorder meet the DSM-IV diagnostic criteria? YES Resolution of diagnosis: A later development or new phase of the same diagnosis. Is there total occupational and social impairment due to mental disorder signs and symptoms? NO If there is not total occupational and social impairment, due to mental disorder signs and symptoms result in the deficiencies in the following areas… Judgment-YES Thinking-YES Family Relations-YES Work-YES Mood-YES School-YES

When I had the )% rating given to me I wasn't that bad off. I mean I was still married, Just got out of the Marines and had only been out of Iraq for 2 months. That is when things first started turing sour for me. I am service connected for my right ankle at 0%, distal esophagitus 0%, Anxiety 0%, and tennitus 10%. My chronic conditions are my right ankle, distal esophagitus, and anxiety. I have filed for an increase for these 3 problems and only these three. i have flat feet but i am not even going to start with that untill i get a rating on these probs. My C&P write up mentions PTSD and only PTSD... I dont know what to make of it..... Axis I: PTSD directly related to active service. Not diagnosed with depression, his depressive symptoms cannot be separated from mood disturbances associated with PTSD. Not diagnosed with panic disorder, panic symptoms cannot be assigned as a separate diagnostic entity because his hyper-arousal and re-experiencing symptoms are better explained by PTSD Axis II: none diagnosed Axis III: GERD and right ankle Axis IV: combat exposure Axis V: GAF 41 GAF of 41 assigned based on current impairments: the veteran’s PTSD symptoms are unstable. He has made preparations to end his life as recently as 3 weeks ago. His panic symptoms were evident on exam today. His inattention to self care and extreme emotional distress was evident to untrained observers today. He did not meet criteria to be committed involuntarily but did meet criteria for an elective admission to inpatient psychiatry today. Other comments: PTSD was evident in exam today. He meets the diagnostic criteria for PTSD. He had symptoms of anxiety diagnosed on discharge for which is already in service connected. PTSD symptoms evolved as a progression of his anxiety state from active duty. The nexus of his anxiety was from combat action in Iraq. His combat Air crewman award was reviewed, validating his combat service equivalent to being awarded a combat action ribbon in the USMC. Combat air crewman wings are awarded to those who have served as crew members on board combat flights. Specific combat stressor was firing on Iraqi positions while receiving fire from the ground with rounds striking the aircraft near Baghdad in March of 2003. He was afraid of being killed on numerous missions during two tours flying in helicopters in Iraq. Currently he has recurring, intrusive thoughts, nightmares, apprehension, and panic attacks associated with re-experiencing trauma from combat. He goes out of his way to avoid conversations and situations that remind him of combat trauma. His emotional numbing was evident on exam. His hyper-arousal symptoms, particularly hyper-vigilance, and his exaggerated startle response are not explained by any diagnosis except PTSD. No risk factors were elicited that may have made the veteran vulnerable to PTSD.

I do not have an NOD. I have a claim for increase due to symptoms worsening since discharge. My So has taken care of all the VA paper work and I have made damn sure that the VA recieved all the IMO's for my ankle. Unfortunatly I do not have an IMO for the anxiety. I have all the treatment records from the VA for that. I am sure that the esophagitus has worsened and I am sure the Dr i see will concure. I luckly do not have to prove a nexus to the problem so all I have to do is show that it has gotten to a point that deserves compensation. Now if the VA sees it that way is a different story. I actually can no complain on the service of the VA regional office here. I dropped in on them when I was in the area and they were very prompt and curtious to me. I usually call about every wednesday to see how my claim is coming along and they have yet to tell me that I am bothering them. They also have been very prompt with my C&P's as well as offering the PTSD program to me if i elect to go. Hopefuly they will be as fair when they rate my claim. I will totally understand if they cant give me an increase for the Esophagitus, it is my fault for not being progressive about making sure i covered all my claims, and to tell you the truth I did not expect the process to move this fast. It's only been a little 3 months so far. In the past 3 months I have had 2 C&P's, 3 psyc visits, and 1 social worker visit. I had 1 surgery on my right ankle and had to take 4 weeks off due to vairous medical problems. In dealing with my mental health and my mobility, i did neglect the lesser of my problems, ( esophagitus). Thats why i was wondering about if I should just wait. I definatly think that if a rating is not recieved by the apointment on the 9th. I will proabably hand deliver the report to the RO the following week. I feel that would be the best way to make sure that it got to the appropriate place. But who knows... really... the VA is so Hush hush about it all. Thanks again for the input. Ryan

I do not have my C-file. I found this site after I had already submitted the paperwork for the increases. I do, however have every scrap of paperwork the VA has sent me since My EAS in 2005, and my service medical records. I also have a complete record of every MH visit and C&P since I started this Back in Jan. I did not see the VA from May 05 - Jan 08. I was not enrolled in the Va health care system untill Jan when I decided that I deserved an increase on my ankle. The Va then screened me for PTSD when i decided to enroll i the VA system, and it came up positive due to suicidal intentions and sever depression. Thats how all of this started. Thanks for the opinions!

I have been thinking about this alot latly. I am service connected for Anxiety and recently filed for an increase. I am not service connected for PTSD. I had a mental health C&P and it was the one for other than PTSD. The exam and my VA shrink both state that I have significant symptoms of PTSD and have me on meds for Depression and sleep loss. I am wondering if the VA will either change my service connection from anxiety to PTSD, or will they Possibly give me the increase based on my symptoms and relate it to anxiety and leave out the PTSD? If they do that then should I file a seperate claim for PTSD so that the anxiety and depression are covered in one rating instead of 2 seperate ones. I am not service connected for depression and have a 0% rating for anxiety. Any info or opinions would be greatly appreciated.