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How to Get your VA C-File




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    • Full Knee Replacement
      First, if you  have newer x-rays from outside the VA, get them and the reports into your VA med file. The distance from the VA hospital initially is not as important as the distance to a local VA outpatient clinic. But, once you convince the clinic PCP then outside care (consult in VA speak) can be authorized, since the VAMC is farther away than 40 miles. 
    • Dro Review Processing Time
      I sent in an NOD requesting DRO review about two months ago.  Nothing appeared on ebenefits so I sent an ISIS message.   Took them 2 weeks to reply  (ignore their note that days reply would be sent in 5 workdays)   Return meggage said NOD was received but ebenefits is a little behind   Message said a letter was sent to me asking if I wanted DRO review.  Msg said ignore letter because I already asked for DRO in NOD. Here's  the killer.  Average time for DRO review    631 days
    • Code Sheet
      After reading my code sheet I saw I have one of those. I'm rated on my ankle as 5020-5271. It's also static.  To me the code sheet eases the Veterans MNF. I know what my codes are and I know that my contentions are either static or non-static.  This shoulf not be a secret to is at it is vital information. Nor should this be a huge issue to get. 
    • Auto Adaptive Reimbursement
      I'd try to get something in writing concerning changes/refusals, than, "run the flag up the pole" any way that I thought would help. Automatic transmissions are more or less standard these days, so I'd not be surprised about that.  Bureaucratic screw ups in budgets are not a valid reason for failing to provide benefits required by title 38. Looking at things from a different perspective, some vehicle options are often listed as options,even though they are really "standard". A/C and automatic transmissions are just two. Another possible go-around is that different trim levels of the same vehicle have different options as "standard". You could possibly buy a base version, and add options at extra cost, or an up trim version with the "options" already included as "standard". It may be that the VA is looking at what the "normal" buyer options are, and trying to avoid paying for them.  
    • CUE? Not using SMR?
      Yes, if they notice the CUE they can adjust on their own.  I just had the EED adjusted on my initial claims for asthma and left ankle, the rater looked at my entire record while processing my unadjudicated claim for diabetes.  He immediately file a cue and adjusted the EED.  I didn't have to do anything for the EED/CUE. However, my ED was actually a CU they started them in 98 vs. 97.  
    • C&P Exam Results, WTH is going on, Please Help!!!
      Agree with killemall. You got this Navy04, we can't wait for you to come back here and say DONE!    
    • Code Sheet
      Thanks Asknod My problem is finding out the code for the disability.?? PTSD Code has it at 9411&9435 Code for Unspecific Depresssive Disorder VA Notes from  PCP  has PTSD  As : SCT47505003  My Sleep Apnea Notes has the code as SCT 73430006, Some of these I get confused with Insurance Codes  for Insurance Purposes. Jbasser & Jerrel Cook had a blog talk radio show on these rating codes Last year some times Maybe I'll recheck the Archives Shows. I tried to look up the code for OSA but never found it. just the SCT #73430006..?  And I have a Boo-Coo List of NSC disability's/contentions.  with the SCT# at the end of them
    • Auto Adaptive Reimbursement
      Update. My friend talked to the head of prosthetics in Tucson(kristine) and she informed him that the VA will not cover some items like power options,automatic transmissions and a few others.(I can't remember the list of things he told me).These were all covered by the VA previously.
    • NOD / DRO or TARP?
      All, Thank you for the response's. Due to me posting all of my documents intermittently, there seems to be some confusion with the timeline and issues. I will attempt to run thru this chronologically and repost all documents including my 2015 decision which I had not previously posted and answer all questions. March 2009- Filed original Claim for the following issues and received results October 2009 (see 2009 - Rating Sheet below) I do not have the entire decision packet: TBI - 10 % SC Residuals, gallbladder removal - 0% SC Back Condition - declined SC Psoriasis - declined SC PTSD - declined SC / Stressor conceded as combat action badge. October 2010 - Filed NOD / DRO for PTSD March - 2011 - Appeal decision received. I never stated that PTSD was due to MST. The paragraph on page 2 of 2011Appeal decision below is just the last part of 10 pages that I cut out covering rules and US code that they sent in the letter. The actual decision starts at the bottom of that page. Results: PTSD declined - I did not submit any new evidence. Diagnosed as "adjustment disorder with mixed anxiety and depressed mood". Blamed on me worrying about my husband returning to Iraq, even though he had just returned??? October 2014  - Initiated following claims: (I had transferred to the North Texas VA and had finally began receiving treatment after being fed up with OKC VA. I live in southern Oklahoma, so its a drive for me to go to either one) PTSD - Re-open Claim. TBI - Request for increase. May 2015 -  I reported for C&P exams at the Dallas VA clinic for PTSD and TBI. I'm not sure if this is relevant, but I received a call while my husband and I were driving there stating that the TBI examiner had to leave early and they would have to re-schedule that exam. I protested because it is a 3 hour drive. They called me back 10 minutes later stating that he would conduct the exam. He seemed pissed the whole time. His notes stated that No TBI residuals were present.  This is also the exam where the PTSD screener stated "However, it should be pointed out that most of the symptoms the veteran described during today's MH examination certainly those common to a PTSD diagnosis- she also described during her 7/8/09 Initial PTSD examination, in Oklahoma City, three years PRIOR to her son's illness."  ( see 2015 C&P exam notes below) June 2015 - Latest decision received. Results (see 2015 - decision part 1 &2 below): TBI - Decreased to 0% SC PTSD - 50% SC May 2016 - Wondering what my best next COA should be? Would like to get PTSD effective date back to 2009 and get TBI increased to at least percentage it was before. I have about 50 days to file my NOD. Q&A: Berta: What did the C & P doc diagnose you with? 2009 - TBI (SC) and adjustment disorder with mixed anxiety and depressed mood (not SC) 2015 - No TBI residuals and PTSD w/ major depressive disorder.   Berta: Have you googled the doctor who did the C & P? I do not know the Doctor's name from 2009. But I have found several articles referring to a Dr. Gail Poyner who was conducting PTSD exams at OKC VA at the time. She was fired from the VA in 2010 for applying test to Veterans to see if they were malingering or faking. Her research paper can be found here: http://link.springer.com/article/10.1007%2Fs12207-010-9076-x?LI=true I would like to have my C-File to see if she conducted the evaluation.   Gastone: What did you claim as the PTSD Stressors in your 09 app for PTSD? Combat Action Badge   Gastone: The 1st Denial, discussed "No Evidence of Personal Assault," MST? No MST ever claimed. The paragraph that covers PTSD due to MST was just the last paragraph of 10 pages of regulations that they sent with the decision. Actual decision starts at the bottom of that page.   Gastone: Did you know anything about the DRO Process Requirement, for the N & M Evidence? I did. My fault I didn't send any. I was fed up with OKC VA and assumed they would send me for a new C&P exam. Stupid on my part.   Gastone: Did you ever get a copy of your 09 PTSD C & P DBQ? No, I did not. Blue button records do not go back that far. I have requested a copy of my C-File. EBenefits states that I will get it between NOV 2017 and NOV 2018.   Gastone:  Do you currently have a VA MH Psychiatrist/Psychologist that treats you on a regular basis? I was being seen at Bohnam, TX VA. After they kept switching Dr's a few times, I now just get my meds re-filled thru my family physician. My husband is active duty, so we are on tri-care prime remote. I also qualify for VA choice, but have not used it.   Gastone: Have they given you an official PTSD DX? I have a PTSD diagnosis and receive 50% SC in 2015.   Berta: Did they have the incident reports? I faxed in two incident reports. They do not show on the evidence list, but stressor was conceded with CAB.   Flores97: Email congressman for C-File. Thank You for the advice. I emailed my congressman today and reiterated the time crunch I am under.     2011 - Appeal decision.pdf 2015 - C&P exam Notes.pdf 2015 - decision part 1.pdf 2015 - decision part 2.pdf 2009 - Rating Sheet.pdf
    • Full Knee Replacement
      I just came back from the Ortho doctor in town he said I need a full knee replacement for my service connected injury after looking at past 11 years of x-rays from the VA and what he just took today. The Marine Corps. somehow don't keep x-rays after a certain period of time. The VA says they will not do one until I'm 60 years old, all they wanted to do was give me injections for the pain. What I have now is a Torn ACL and I'm running bone on bone, and my knee cap is just about gone so here is the question. I already receive 20% for my left knee, due to the past 3 surgery's. So after having the knee replacement what will I be looking at? for an increase? Does the VA have to pay for this since I live 178 miles from the Nearest VA hospital? because they are still telling me if you were injured on active duty you must go to the VA hospital even through the VA says They will not do a knee replacement until I'm 60? I already talked to two Veterans in town at the Vet center and they had the same problem but they paid for it out of their own pocket for the surgery then filed for an increase award. So far they are still waiting for the VA to answer them back. any ideals on the best route to take? I hate to get this done out in a local hospital then fine out the VA will not pay and give me an increase for the full knee replacement. Thank for any information on this subject.

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Erich

C & P Exam For Ptsd

17 posts in this topic

I have a C & P exam scheduled for 10/14/08 and I think it could be to determine if I have PTSD. I filed a claim in Feb 2007 and later amended it to include PTSD. I did this after my last C & P examiner advised me to apply for this.

I saw a young woman in her 20's about nine months ago who screened me for PTSD treatment and she later told me that I have PTSD symptoms but my main problem was Depression.... and therefore didn't qualify for their PTSD treatment program. I think there was more going on than that because even though I was wounded by shell fragments from a grenade, I did not get a purple heart credited to my records. I am 20% service connected for these wounds though.

I was hit in my chest, buttox, and both legs by shell fragments from a grenade that I think exploded on the roof of the bunker I was in. My CO had already identified me as a "pot head" and was in the process of giving me an "Undesireable Discharge" when I got blasted by grenade. I was not offered drug rehab which sucks... [My discharge was upgraded to Honorable about a year after I got out in 1971] However, to further complicate matters, my Squad Leader was a homosexual who had twice made advances towards me. Both times I woke and he was sitting up next to me on my bed. The 2nd time I rept him to my CO who I believe did nothing. I think there is a good chance this Sgt might have been behind the grenade that got me???

Anyway, when they screened me for PTSD treatment I had to take a 500+ questionaire which was a big problem for me. I was unable to concentrate and focus on the questions after about 30-40 minutes [about halfway thru] and it also gave me a headache. So the last 200+ questions were probably not answered right?? I'm concerned they might ask me to do this again... is this part of the C & P exam for PTSD?

I called Indianapolis VARO and asked them if this exam is for PTSD and they wouldn't tell me. The lady just said it was to further evaluate my condition. Then she said she needed to document my file that I had called...

I know there is a lot at stake and I'm very nervous. Can anyone tell me what I can expect if this exam is for PTSD?

Also... I'm told I can't get Depression service connected because I didn't seek treatment in the service or within 1 year of discharge. Can someone confirm if this is true?

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Just tell it like it is about your Vietnam experience and your wounds. If the wounds are SC'ed then I think that should be a verifiable stressor for PTSD. Google PTSD and read all the symptoms so you are familiar with it. They may ask you if you are afraid of crowds or if you have dreams or flashbacks to the events in Nam. They may ask if you are hyper vigilent and uptight and expecting combat situations to return. I would go easy on discussing my drug history. Focus on the grenade attack and how that has left nervous and unable to relate to others. You don't know if the VC or your SGT tried to kill you so you don't trust anyone. You need to have symptoms of PTSD. Don't let them steer you towards problems before the service in your childhood or high shcool or with the law.

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something i always tell ppl, it might sound silly but.......if there are any "yes" or "no" questions always answer them! never say "i don't know" because that leaves the door wide open for them to fill in whatever they please.

i know others on here have stressed that it's important how you dress. yup. you read that right. don't dress up. just wear what you wear everyday...the last thing you are there to do is impress them.

that long test you mentioned? the MMPI probably--i don't recall having to re-take that at my C&P exam, but that was several years ago and yes, that test sucks.

take care,

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Index to Disability Examination Worksheets http://www.vba.va.gov/bln/21/Benefits/exams/index.htm

These 57 Disability Examination Worksheets are in use both by the doctors of VHA (Veterans Health Administration) who do the disability examinations and by the rating specialists, hearing officers, and Decision Review Officers of VBA (Veterans Benefits Administration) who do the disability evaluations.

STUDY BOTH

Initial Evaluation for Post-Traumatic Stress Disorder (PTSD)

Mental Disorders

Edited by Wings

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This is a good VA Manual. ~Wings

Best Practice Manual for

Posttraumatic Stress Disorder (PTSD)

Compensation and Pension Examinations

URL http://www.avapl.org/pub/PTSD%20Manual%20final%206.pdf

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be honest, don't try and suck it up at the c and p exam, like the man said just tell it like it is

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Thanks to all for your input... I can't help but feel very anxious and nervous about the exam. I do plan to tell the examiner the truth. I just hope I can remember all the problems this has caused me over the years. Right now I'm afraid my 3rd marriage is going down after 18 years but I don't blame her. I am no good to her sexually, socially, and our kids don't really like me.

I spend about 95% of my time in a back room of our house. I hate being stuck in that room but hate leaving even more.

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Erich, thanks for signing on to Hadit. Took me a few months to get courage to start talking here, but sure saved me from bottoming out over the past few years. I don' have medical training at all, just a proactive "Hadittude'! Now I have copy of my smr's (service medical records) and c-file and va medical records, records from civ docs (only keep em 7 years) and more.

Are you getting medical care through a private doc now for depression or other health things that could be related to ptsd? If so, to help you, request a statement from the doc how the ptsd or symptoms impact your health.

Don't know myself, may be good that your c&p is coming up. or not, Hope you remember its a one time pony show, use the exam sheet as a guide; you'll do fine. Remember examiners aren't hired for follow on care, so if you need help, ask for it. The va should help. Hey, I went to primary care, during an intake they asked if I was ok. replied 'nope.' Told me where mental health offices are. I just walked into the clinic and said "I need to talk to a counselor for help'. That worked for me.. Can't tell how things will turn out for any of us myself, just want the best for every vet and precious families.

Best to ya,

Cg

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Have you written a Stressor Letter to outline your verifiable stressor which would be the grenade attack to my way of thinking. Did you get any combat awards or were you in any firefights or rocket attacks you can verify? I think the grenade attack is enough to be a good stressor. For PTSD you need a verifiable stressor. That is the difference between a depression claim, for instance, and a PTSD claim. The depression claim could flow out of your wounds and the pain and disablility they cause, but that is another route towards a rating for a mental condition other than PTSD. The way the military treated you is the real stressor but that does not count in their military minds. I would stress the grenade attack and how your relive it over and over again every time you hear a loud noise. Just a suggestion.

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Thanks again for the additional comments. I have not got any outside help for my problems for over 10 yrs. I contacted both of those Dr offices and they don't have any records now. One of those Dr's told my wife that Vietnam had a profound effect on my life...

The army must have taken the position my wounds came from a "fragging" since they did not put PH in my records. Our camp did get hit with mortors/rockets a couple of times but nothing close to me... Was also in a convoy that came uder fire but again nothing close to me. I think my focus will be on getting blasted by the grenade because that is "straw that broke my back". Before that it was all a combination of fear, stress, insomnia, malaria, boredom, and the sex harrassment that got to me. Was on duty in perimeter bunker 12 hrs nightly 7 days a week... I felt like I was between rock and hard place with drug problem and Squad Leader targeting me as his next conquest. I still think he was most likely one behind the grenade attack because it happened after I rept him to CO.

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Doing perimeter guard 12 hours a day and seven days a week would drive anyone crazy or to drugs. 99% of the time nothing happens and when something does happen your dead.

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Erich,everyone gave you some good information,but make sure you read and comprehend what john999 wrote,because that is some very good information.If you are still having flashbacks about getting wounded by that grenade, that is a stressor withthan itself and you definite have PTSD.(1)Being diagnose with ptsd (2)Wounded by grenade (3)Having nitemares about it.those are the three things it takes to get service connected for post-traumatic stress disorder,but remember you have to be diagnose by a clinical psychologist or a psychiatrist and it is best to get you a private psy.

mobie

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Thanks to all for your input... I can't help but feel very anxious and nervous about the exam. I do plan to tell the examiner the truth. I just hope I can remember all the problems this has caused me over the years. Right now I'm afraid my 3rd marriage is going down after 18 years but I don't blame her. I am no good to her sexually, socially, and our kids don't really like me.

I spend about 95% of my time in a back room of our house. I hate being stuck in that room but hate leaving even more.

Hi Erich. When you go to the exam, you might want to bring your wife if you are married. Or bring someone to the exam that is very familiar with your PTSD symptons, behaviors, etc. Good luck.

Also, as others have said, the "verifiable" stressor(s) are VERY important. I am not sure how they verify it, but im sure records for the unit/company/battalion you were attached to, plus the approximate dates of the attacks, are stored someplace...probably St Louis MO.

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I had my C & P exam and my wife went with me. She stayed for about an hour and gave all her input. Then I told the examiner my story. It was hard for me to tell everything especially about the sexual harrassment and drug dependence. But I told him all that I remembered. A week later I had a clinic appt and the Nurse Practioner told me I was diagnosed with PTSD from C&P exam. I didn't feel comfortable asking him about details of rept. I was just relieved that someone finally heard me and believed what I had to say.

I have since been referred to the "Vet Center" and had appt with the Director. He set me up with an individual therapist next Tues. He also said they will probably put me into a weekly group which I am looking forward too.

I plan to wait a month or two to let the process work and see if they come up with a fair rating. In the meantime I hope to get better with the support of the Vet Center.

Thanks again to everyone for your help and advice

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Erich

Stay in treatment regardless of your rating. The initial rating is just the beginning of the process usually. If you get 50% rating for PTSD you want to eventually get your 100% or IU. The way to do this is to stay in treatment so you build a mountain of documentation. Don't get a rating and then disappear. Make the VA work for you.

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Erich,everyone gave you some good information,but make sure you read and comprehend what john999 wrote,because that is some very good information.If you are still having flashbacks about getting wounded by that grenade, that is a stressor withthan itself and you definite have PTSD.(1)Being diagnose with ptsd (2)Wounded by grenade (3)Having nitemares about it.those are the three things it takes to get service connected for post-traumatic stress disorder,but remember you have to be diagnose by a clinical psychologist or a psychiatrist and it is best to get you a private psy.

mobie

mobile,

take her with you okay i think it will really help do not loofe this one too

Bill

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My husband couldn't even finish the tests, which actually ended up working in his favour.

If you need to take a break because the questions are bringing up stuff tell them, this will be noted in the C&P findings, take a break for 5 minutes and sit back down and try again. Take as many breaks as you feel you need to. Don't let anyone pressure you into a timeslot. My husband took 5 hours to complete one test, and they had to let him.

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