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    • @Keli  I am positive that you will find plenty of veterans to interview in Houston and the surrounding areas. Best of Luck with your endeavor. I am from Louisiana and have to go to Shreveport, Louisiana VA Hospital "Overton Brooks" if you ever need someone from my area. Just a few questions if I could ask them: 1) What specifically is it that you are aiming for?    a) C/P Exams in general    b) C/P Exams by Nurse's not by Doctors    c) C/P Exams where they do not use evidence to support claim, but rather only use what evidence they feel is needed for just that one exam. 2) How the VA does or will not send you to the proper Certified Medical Examiner?    a) How the VA uses Nurses to examine Veterans for a specific condition and not that of a certified medical doctor.    b) How the VA manipulates who is seen in orthopedics and when.    c) How C/P Nurses can falsely fill out a DBQ ( Disability Benefits Questionnaire ) that affects the outcome for Benefits and Retro-active pay. 3) How DRO or RO ( Decision Review Officer or Review Officer ) will send the Veteran for a Examination with a Nurse.    a) C/P Exams are done by nurse's now and does not have to be certified by a doctor.    b) C/P Examiners ( Nurses ) only have to pass the exam the VA gives on how to fill out the paperwork.    c) C/P Nurse Examiners are not Board Certified Medical Doctors   But in all instances the VA has decided to use the Nurses in place of Doctors and the outcome has shown that their lack of medical knowledge and experience affects the outcome of the veterans claim. I am one of those who has been examined by Nurse's and on all three instances they did not have the medical background or experience to be giving Medical Opinions. Here is a analogy that may help you understand the difference in Quality Care and Quanity Care. Analogy: Would you go to a eye doctor for a colon scope? Would you go to a podiatrist for a heart by-pass?   Imagine your health care benefits for minute.... When you have problem with your back you go to a Orthopedic Doctor. They will run a MRI - Cat-Scan - X-rays to find the source of the problem and see if affects your legs with numbness or pain that radiates down your leg. For most veterans they send us to x-ray and have the technician read the results. Not a Radiologist. When it comes to your health Do you Trust a nurse playing Doctor or Do you Not trust their unknowledgeable and unexperienced Opinion?  Doing stories or news reports about veterans not being treated fairly is not the Top Headline Stories needed to turn the VA around. What is needed is to make the firing of wrong doers stick. And in my little opinion even knowing that VA supervisors can just go to court and the courts turn around and say that they can not be fired. Well in all honesty if we Impeach the President and other Officials. We should in our own rights be able to Impeach any federal employee that has or repeatedly harmed my fellow american veterans and taken some of lifes with their dirty little tricks.  
    • @Gastone 38 CFR 3.310 says this about secondary service connection:

      "When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition so.....if I am reading this correctly, they ARE connecting the bladder to the PTSD/MST claim. is important to recognize that certain types of chronic pain are more common in individuals who have experienced specific traumas. For example, adult survivors of physical, psychological, or sexual abuse tend to be more at risk for developing certain types of chronic pain later in their lives. The most common forms of chronic pain for survivors of these kinds of trauma involve: pain in the pelvis, lower back, face, and bladder; fibromyalgia; interstitial cystitis; and nonremitting whiplash syndromes (17). my diagnosis for my bladder is intertstial cystitis.  The above statement is directly from the VA.
    • Deliberate CUE Mistakes, a scary thought. I've only been at this since 08 and this is the 1st claim out of about 9 Awards that I had an EED Issue with. I prefer to believe that most Claims Decision Errors are the result of Raters that are less "Issue Specific" competent, than they should be. If it weren't for the VA Quality Control Review of the 7/15 FDC Decision and a Mucho Quick VA  Decision on my CUE Review Request, I'd be on the DRO Hearing Train again, last time, took 4.25 yrs. A great (retired VA DRO) Detroit Marine Corps League Rep (DRO Hearing Specialist) recommended the request for "Cue Review."  In error, I was somewhat skeptical regarding any type (Official or Unofficial)  request for a Decision Review. Being only a month since the Decision Letter,I decided to give it a go. Worked out for me. Semper Fi
    • Thank you all for your insight. I had a C&P increase about 4 months ago and it eBenefits was still saying gathering evidence so I was just curious. I realize my RO is Chicago so I am assuming it takes much longer than my previous initial claim which was in Louisville.
    • This is the same dilemma I'm facing.   Requested a copy of my brother's April 2016 C&P Exam.   Completion date of 2/18 - 2/19 is noted on eBenefits.   Review of this exam is crucial for Notice of Disagreement and supporting evidence for PTSD/Schizophrenia service connection.    Even have a psychologist waiting in the wings to critique the exam when I get it.   Looks like if and when it comes, it will be well past the 1-year deadline.   The VA needs to address this wait problem.   Veterans are entitled to receive their service medical records expeditiously.    





USSOkiewife

Va Using Ssd Disability Rating

8 posts in this topic

We recently learned the VA has used an original SSD records for disability to establish a low SC rating for PTSD. My husband has all the criteria for SC PTSD - combat ribbons, etc. He was given a low 10% SC for PTSD as the SSD records hold no evidence of PTSD, but determine his serious mental health condition to be Schizoaffective disorder. Later medical evidence ( C&P) discovered the PTSD and established it as being the main mental health condition, even pointing out that without the trauma piece a correct diagnosis was possible. The VA agree his condition is severe but points to the SSD records done before his claim for SC PTSD as being the major mental health issue - one which, due to its lack of earlier connection - to be non-service connected. Has anyone elsehad this problem? He is appealing the low rating and it looks to be in his favor.

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Does the VA have your husband rated for PTSD or is it using Social Security to award to claim his PTSD is after his service?

What is 20% rating for?

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If your husband served in combat and got honorable discharge for a full period of service I think the schizoaffective disorder DX is suspect. He probably needs a private doctor to rebutt the VA's contention that PTSD is a minor % of his total disability. Was he ever treated for any mental health condition in the service? I think it is impossible to separate out MH disorders if there is a stressor like combat service. This stress could be the ultimate trigger for any MH condition. Probably many vets got medical discharges for MH conditions before PTSD was even recognized. When soldiers have complete nervous breakdowns due to acute combat fatigue what are the residuals of that in later life? No one knows.

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I have encountered several claims where the VA used reports from outside agencies to discredit a veterans claim. I was successful in having the reports from the outside agencies thrown out by a DRO. The reason the DRO will throw out the reports is because reports from the outside agency were not developed in accordance VA evidence rules.

You need to file an appeal for an increase in the 10% PTSD rating if you disagree. Have a service officer assist you. To support your appeal you can take a full attack. You need to discredit Social Security report and strengthen the claim for PTSD. It is most important to strengthen the claim for PTSD. In the long run the Social Security report should have no bearing on the claim. It is entirely possible that the Social Security report was not really the reason the claim was low balled. They could be citing Social Security report just to confuse you. You'll spend so much effort discrediting Social Security report that you will forget to strengthen the PTSD rating. You can file an appeal with no new evidence and hope a DRO will see through the problems. However, I would obtain new reports from clinicians as described later in this post.

Your first attack will be to identify exactly how the PTSD was rated. The exact language in the rating decision is important. Raters do not use any single criteria, measurement or descriptive language of the disability for the purpose of assigning a percentage. They are allowed to base their rating determination on what they perceive as the overall diagnostic picture. This incorporates GAF scores, records of hospitalizations, treatments, and negative impact on social and industrial functioning.

It appears that there have been no treatments or hospitalizations. You did not discuss any inability to obtain or maintain employment. You did not discuss any difficulties in interpersonal relations. You do say that the VA agrees his condition is severe. Who at the VA told you this? Was it some guy sitting behind a desk? What does the C&P exam say in regards to the disability.

It is hard to rely on reports from examining physicians. This includes Social Security and VA compensation and pension exams. The strongest evidence would be from treating doctors. I would recommend that your husband enter a treatment program either at a VA hospital or a veteran’s center. They pretty much know what to do. However, they need to assign a new GAF score. They need to identify how the disability affects employment and social functioning. The best way to advance a claim is with new and stronger evidence.

It should be fairly easy to shoot down for Social Security report. Especially since the C&P examiner commented that the schizoaffective disorder did not take into consideration the criteria for PTSD. The schizoaffective disorder diagnosis appears to me to have been based on a single exam. Did Social Security have any treatment notes available to them prior to the exam they performed?

It also appears that the rater may have over used or abused their discretionary power. The weight given to each diagnosis in a case which involves multiple diagnoses of mental conditions is performed by a clinician on a mental health exam. The C&P examiner should have identified how much of the disability is attributed to the schizoaffective disorder and how much of the disability is attributed to the PTSD. These questions are asked on the exam worksheet. It appears to me that this comparison was not performed because the C&P examiner thought that the schizoaffective diagnosis was based on incomplete information. In the absence of such a comparison by the C&P examiner I do not feel the rater has the authority or discretionary power to fill in the blanks.

Once again, I want to restate the importance of strengthening the evidence for the PTSD diagnosis. I do not see how you can obtain a high rating for PTSD if the C&P examiner did not identify a significant impact on employment and interpersonal relations. The exact terminology could very. However, a low GAF score combined with the identification of the impact on employment and interpersonal relations would be necessary. Hospitalizations and treatment programs also add to the diagnostic picture.

I am pretty sure that there is a link on hadit to an explanation of how mental health disability is rated.

Edited by Hoppy

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Excellent info Hoppy!

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I have encountered several claims where the VA used reports from outside agencies to discredit a veterans claim. I was successful in having the reports from the outside agencies thrown out by a DRO. The reason the DRO will throw out the reports is because reports from the outside agency were not developed in accordance VA evidence rules.

You need to file an appeal for an increase in the 10% PTSD rating if you disagree. Have a service officer assist you. To support your appeal you can take a full attack. You need to discredit Social Security report and strengthen the claim for PTSD. It is most important to strengthen the claim for PTSD. In the long run the Social Security report should have no bearing on the claim. It is entirely possible that the Social Security report was not really the reason the claim was low balled. They could be citing Social Security report just to confuse you. You'll spend so much effort discrediting Social Security report that you will forget to strengthen the PTSD rating. You can file an appeal with no new evidence and hope a DRO will see through the problems. However, I would obtain new reports from clinicians as described later in this post.

Your first attack will be to identify exactly how the PTSD was rated. The exact language in the rating decision is important. Raters do not use any single criteria, measurement or descriptive language of the disability for the purpose of assigning a percentage. They are allowed to base their rating determination on what they perceive as the overall diagnostic picture. This incorporates GAF scores, records of hospitalizations, treatments, and negative impact on social and industrial functioning.

It appears that there have been no treatments or hospitalizations. You did not discuss any inability to obtain or maintain employment. You did not discuss any difficulties in interpersonal relations. You do say that the VA agrees his condition is severe. Who at the VA told you this? Was it some guy sitting behind a desk? What does the C&P exam say in regards to the disability.

It is hard to rely on reports from examining physicians. This includes Social Security and VA compensation and pension exams. The strongest evidence would be from treating doctors. I would recommend that your husband enter a treatment program either at a VA hospital or a veteran's center. They pretty much know what to do. However, they need to assign a new GAF score. They need to identify how the disability affects employment and social functioning. The best way to advance a claim is with new and stronger evidence.

It should be fairly easy to shoot down for Social Security report. Especially since the C&P examiner commented that the schizoaffective disorder did not take into consideration the criteria for PTSD. The schizoaffective disorder diagnosis appears to me to have been based on a single exam. Did Social Security have any treatment notes available to them prior to the exam they performed?

It also appears that the rater may have over used or abused their discretionary power. The weight given to each diagnosis in a case which involves multiple diagnoses of mental conditions is performed by a clinician on a mental health exam. The C&P examiner should have identified how much of the disability is attributed to the schizoaffective disorder and how much of the disability is attributed to the PTSD. These questions are asked on the exam worksheet. It appears to me that this comparison was not performed because the C&P examiner thought that the schizoaffective diagnosis was based on incomplete information. In the absence of such a comparison by the C&P examiner I do not feel the rater has the authority or discretionary power to fill in the blanks.

Once again, I want to restate the importance of strengthening the evidence for the PTSD diagnosis. I do not see how you can obtain a high rating for PTSD if the C&P examiner did not identify a significant impact on employment and interpersonal relations. The exact terminology could very. However, a low GAF score combined with the identification of the impact on employment and interpersonal relations would be necessary. Hospitalizations and treatment programs also add to the diagnostic picture.

I am pretty sure that there is a link on hadit to an explanation of how mental health disability is rated.

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