This eBook will teach you how to get C-Files (paper and electronic) from the VA Regional Office.
How to Get your VA C-File


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    • Is it possible to back date ability pay to time of injury?
      I deployed in 2007 to Iraq. Came home and served the remainder of my contract, ets'd, and began claiming disabilities staring with PTSD. I was awarded 50% in 2012. I was given back pay for the 6 or so months that it took from the time i filed the claim until the time they awarded me 50%. Recently, a friend that i served with filed for a TBI that he received during a 2011 deployment. He was awarded 80%. Instead of giving him back pay from the time he filed, he received back pay all the way back to the time of injury. Needless to say the amount was tens of thousands of dollars. Now my question is, is there some way i can have my original rating of 50% back payed from my deployment in 2007 instead of just from the time i filed in 2012?
    • Feeling Hopeless - this can't be right.
      Dear Veterans, I just received another denial letter from the VA for my Left Knee and Sleep Apnea service connection. I'm currently working with a VA Claims Specialist in Long Island, New York to help me with the claims process. He has told me we will have to file a Notice of Disagreement / De Novo Review for the Left Knee and Sleep Apnea. He also advised me this process could take up to 1-2 years. This is unfortunate and I want to make sure the VA has everything they need to give me the proper decision.   I've attached pictures of my original claims from July 2013, and the decisions I've received for Sleep Apnea and my Left Knee condition in May 2016. I originally submitted my Left Knee claim right before I got out in July 2013 and I was denied. I dislocated my Left Knee cap in 2012 while in service. Since 2013 my knee has gotten worse, I've attended many months of physical therapy and I recently had surgery in March 2016. My knee is now worse after the surgery, I'm unable to run and I'm still in physical therapy. All of this is coming out of pocket because the wait times were too long for physical therapy at the VA Hospital, and I didn't trust the VA with surgery. I was unable to submit the surgery to the VA because I received surgery after I submitted. I've submitted two (2) lay statements, a physical therapy report, and VA examination which was requested by the VA. The VA examination explained that I couldn't stand up for more then 15 mins without pain and that my knee would lock up making it difficult to walk.  I was diagnosed with Sleep Apnea in October 2013, just 3 months after I got out in July 2013. I submitted the claim a few months after because I wasn't sure about the claims process. I've submitted two (2) lay statements from Marines I deployed, lived and served with. I also have the doctors report from the VA hospital sleep study. With all this evidence I was still denied the claim. When I spoke to the VA rep on the phone they told me they didn't have my lay statements, however, the VA Claims Specialist I'm working with said this wouldn't matter because I was diagnosed within a year of discharge. I'm currently 50% with Anxiety and Depression and I have a special purpose claim for Erectile Dysfunction. Furthermore, the Left Knee claim is coming up as (New) on eBenefits even though I originally submitted in July 2013. Once I receive a decision will they back date the claim to July 2013 or from when the new claim was submitted? I appreciate all the help and suggestions you can offer.  Semper Fi
    • My C&P Results and why i'm disturbed
      Cobra4v: Yes; I'm at 90% also and got low-balled and denied on several of my contentions. I was hoping to get this corrected via my NOD but although I ordered my C-File 11 Months ago, it will be at least another 6-8 months before I see it. A few Vets on this Forum Suggested that I go to VA Secretary McDonald but we should not have to do that. I was not able to get new exams but it's really unfair that folks with NODs and other actions should be given priority for their C-Files. Frankly, FOIA says that the government has only 20 days to answer FOIA requests within that time period and then they are in violation of the law. I'm not a fan of lawsuits but VA needs to either meet these legal suspense's for FOIAs and C-Field or pay a penalty to Vets that are unable to meet their own suspense's and the VBA required suspense's for NOD's and Appeals. That said, like most Vets we just need to keep chipping away like ASKNOD over years to get what most vets deserved in the first place. Good Luck and Godspeed on your endeavors -Rootbeer22     
    • IME and Physician conflict of interest
      Old Joe I would say Veterans are fine as long as the "benefit of doubt" does not go out the window. Most folks resort to an IME/IMO because the VA is scandalous, the VA breaks the law and goes against clear, crystal clear, regulations.  It is only with an IME/IMO that you can blow their hired docs BS out of the water. The system is a completely adversarial nightmare, even though the law states differently. That is the way it is.  I don't agree with it, and I don't put up with that crap, just like most of us, Veterans and dependents, who fight for benefits and win, not because the VA finally gave in, but because the VA can't keep dodging the law. As long as we, Veterans alike, keep fighting,we will be victorious, because the regulations and laws state when we are in the right.
    • IME and Physician conflict of interest
      You have about 3 choices: 1.  Wait for this doc. to respond.  2.  Go ahead and look for another doc. 3.  Do nothing.   I recommend you wait a reasonable period, but then go to number 2.  I dont recommend number 3.  
    • Osteoarthritis in right knee
      "Presumptive" condtions is only ONE of the methods to get service connection.  There are also, direct, secondary, and caused by VA such as an 1151 claim.  What you need is: 1.  A current diagnosis of Osteoarthritis. It sounds like you got that one.  2.  An inservice event or aggaravation.  You probably have this, too, but proving it may be difficult if its not documented.   3.  Nexus, or medical link between 1 and 2 above.  The doc needs to state something close to your osteo arthritis is "at least as likely as not" due to (xx event in service, such as much marching, heavy backpacks, long hikes jumping out of airplanes, etc).  
    • IME and Physician conflict of interest
      That said is there anything being done about IME/IMO this seems to be getting a bit ridiculous that in a "non-adversarial" system that a vet has to get a IME/IMO just to stand a chance of getting properly assessed (even low balled). And the more I seem and hear it sounds like IME/IMOs will soon start to be discounted because all the vets are doing them just a standard practice when filing a claim. Then where are we going to be?
    • IME and Physician conflict of interest
      In other news, got a nice surprise when the VA awarded me retroactive pay for tinnitus. Have filed NOD, through DAV.  Rep is a cantankerous old man, I think he is kind of neat, just hope he lasts long enough to see my claim through (unfortunately he is not what you could easily confuse with a spring chicken). But it does give me some warm fuzzies that even was even dumbfounded when he read my initial rating letter that it explicitly left out the key evaluation concerning my back.  That alone should have one the "benefit of the doubt" rule.  Unfortunately I know they they wrote it off by using their "expert" as not being probative vale. Got to love how they can twist a few things in order to deny a claim.  And then conveniently ignore last little part of Title 38 CFR §3.156(a) about raising a reasonable possibility of sustaining a claim.  Yes the evidence may be cumulative, but that said the evidence displayed continued symptomology.  Seen several claims before the BVA with very similar circumstances and not have an IME/IMO.  
    • IME and Physician conflict of interest
      Still waiting on this Dr to get back with me, hope he does it soon. I know with the holiday weekend I am willing to give the benefit of the doubt that it played a hand in getting back with me.
    • My C&P Results and why i'm disturbed
      Absolutely correct. 90 is very hard to be at. I'm at 90 even right now for my cumulative. I just completed an increase C&P exam for my Bil knees, right shoulder, and cervical spine. Hoping for 100% because my days OTJ are limited at best. But I definitely want to continue working. (My wife drives me crazy)

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AFMedic09

Denied Ptsd?

16 posts in this topic

You can find the exact verbage under the "Success" forum. However, my question is this: I was denied for PTSD/depression due to no evidence of current disability. Not sc, no 0% under what they decided on. BUT on another page it says I am sc'd for adjustment disorder with depressed mood for purposes of treatment as I was diagnosed with PTSD/depression in 2001. (joined in 1999) I have never seen any diagnosis of adjustment d/o in my medical records so this must be something the c&p dr said. However, what does this mean? I have not even a 0% rating in my paperwork for this - but I can be seen for it? They gave it to me based on my C&P but denied my claim? Can anyone shine light on what their thinking is and what this means? Should I NOD? I haven't been seen except once since separating, just trying to handle life on my own. I know I need medication- this process is proof of that. I just don't understand what it means? Thanks for any help you can offer.

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Sounds like treatments for medical purposes only. Not an sc condition. This is a new thing for gulf war vets who need treatment for mental issues even if cant be seen for anything else. Don't quote me on it. Read the rating decision and see if it says for medical treatment only

Edited by T8r

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If you're truly suffering from PTSD get treatment asap. Find out what your treating doctors are calling it if not PTSD. Work on your stressor letter and gather evidence. You should start PTSD treatment then file NOD.

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It seems to me the VA is saying you do not have a current DX of PTSD or Depression because the VA can't find any current evidence of your having it. Read up on symptoms of PTSD and see if what you told the VA matches those symptoms. If you told them that every time you hear a loud noise you flashback to combat then the VA is just trying to play a game with you. Do you have any combat medals or badges? You need the stressors and you need the current symptoms. The stressors have been relaxed but what you get is the kind of crap you got with the VA pretending they don't see symptoms.

John

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It isn't just VA doctors but all doctors. They're funny on what they call your condition. Some might call it PTSD, anxiety, schizophrenia, or some other condition.

Do an online quiz to see if you have PTSD. Take that to your mental health doctor and say, "see this test? I think I have PTSD." You have to remember it is important to get the correct diagnoses. PTSD or not your number one goal should be treatment. Hang in there.

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I was diagnosed with PTSD and depression in the military. Was on Prozac and went through years of therapy sessions. Since separating I have had to work full time, and over time as the economy is terrible & my ex doesn't pay child support so it's all on me. I am goint to start therapy again. Having more frequent bad days. I told the C&P dr. that I can't sit with my back to the door, I have had panic attacks due to boxes on side of road (WHO DOES THAT?!?!?!?!!!) etc. The letter says they see where I was diagnosed with PTSD in the military, but that basically since I'm not being treated currently they wont SC. Not even 0%? But they sc'd for purposes of treatment. I don't know. I am going to start seeing a psych. and start complaining instead of carrying all of this around in me..my family will appreciate it. and then I will NOD. I just don't know why they didn't give me 0%. THey gave me 0% for restless leg syndrome, and I'm not being treated for that currently. (makes no sense what they sc'd and what they didn't) I was in therapy for YEARS. I have a combat ribbon. My diagnosis throughout treatment was PTSD & depression.

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You can find the exact verbage under the "Success" forum.

AF - Below is what you posted over in the Success forum.

"Service connectsion for adjustment disorder with depressed mood for the purpose of establishing eligibility to treatment.

A determination of service connection under 38 U.S.C. 1702 is for the purpose of providing eligibility for hospital and medical treatments for veterans of WWII, Korean Conflict, or Vietnam era: or for Gulf War veterans who develop an active psychosis or any active mental illness during or within two years from the daate of separation from such service or within two years of the end of the war period, whichever is earlier. The veteran was discharged on November 16, 2009. A psychosis/mental illness was first diagnosed on March 6, 2001 while you were on active uty. Entitlement to treatment is established because a psychosis/mental illness was diagnosed within the required period of time. Service connection for the purpose of establishing eligibility to treatment is established."

However, my question is this: I was denied for PTSD/depression due to no evidence of current disability.

AF - The above does not even specifically address an anxiety (PTSD) or mood disorder (MDD).

It only states a "psychosis/mental illness".

So far, from what I've read posted, you have not received a decision denying "PTSD/depression"

Please, get your rating decision and post exact what is on it, that pertains to mental health under:

ISSUES

EVIDENCE

REASONS

Not sc, no 0% under what they decided on.

BUT on another page it says I am sc'd for adjustment disorder with depressed mood for purposes of treatment

as I was diagnosed with PTSD/depression in 2001. (joined in 1999)

AF - Post exactly what is stated on the decision.

Another thing to keep in mind (this is the way I see it) -

they have SC'd a mental health condition (other than eating disorder) for

"the purpose of establishing eligibility to treatment".

Again, PTSD has not been denied BUT at this point I don't even see where you really need to argue

for PTSD.

To me - the objective goal is to get SC'd for a mental health disorder( if you have one that is

related to active duty) and receive your benefits of medical treatment and compensation for it.

I have taken on the mind set of - it does not matter if they grant under PTSD / MDD / Panic Disorder /

etc ...

They have already stated that:

"A psychosis/mental illness was first diagnosed on March 6, 2001 while you were on active uty".

IMO - this will need to be developed more and it's real important to see exactly everything

the decision states about it.

I have never seen any diagnosis of adjustment d/o in my medical records so this must be something the c&p dr said.

However, what does this mean?

AF - If your C&P was done at a VAMC - go there to Release Of Information (ROI) and get a

copy of the C&P, in fact get copies of all the C&P's you've had while waiting on this decision.

I have not even a 0% rating in my paperwork for this - but I can be seen for it?

They gave it to me based on my C&P but denied my claim?

Can anyone shine light on what their thinking is and what this means?

Should I NOD? I haven't been seen except once since separating, just trying to handle life on my own.

I know I need medication- this process is proof of that.

AF - I would not do anything further until you can post the answers and members can help out on this.

What I would do is start making some VAMC appointments for mental health care (and medications if needed)

ASAP.

JMHO - carlie

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I was diagnosed with PTSD and depression in the military. Was on Prozac and went through years of therapy sessions.

AF - do you have copies of the above from your SMR/STR's?

Are they listed in the evidence section of the rating decision?

Is the above addresses any where in the rating decision?

Since separating I have had to work full time, and over time as the economy is terrible & my ex doesn't pay child support so it's all on me.

AF - if your Migraines are not, "very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability" (don't your ability to earn a living) , you might not get higher than the 30 percent that

was granted.

The VA is not concerned with the economy or your ex not paying child support as it does not

have any relationship to claims for benefits.

In the recent grant of 40 percent, at least VBA will provide additional compensation cash for your dependents.

Be sure to file for it properly, if you haven't yet.

I am goint to start therapy again. Having more frequent bad days.

AF - You have established eligibility for mental health care - make some appointments.

I told the C&P dr. that I can't sit with my back to the door, I have had panic attacks due to boxes on side of road (WHO DOES THAT?!?!?!?!!!) etc.

AF - Get a copy of the C&P.

The letter says they see where I was diagnosed with PTSD in the military, but that basically since I'm not being treated currently they wont SC.

AF - I don't see anywhere yet exactly what the decision states. Please post it.

Not even 0%? But they sc'd for purposes of treatment. I don't know. I am going to start seeing a psych. and start complaining instead of carrying all of this around in me..my family will appreciate it. and then I will NOD. I just don't know why they didn't give me 0%.

AF - I wouldn't just file a hap-hazard NOD in response.

THey gave me 0% for restless leg syndrome, and I'm not being treated for that currently. (makes no sense what they sc'd and what they didn't)

I was in therapy for YEARS. I have a combat ribbon. My diagnosis throughout treatment was PTSD & depression.

AF - where were you in therapy at? What exactly is your "combat ribbon" and who and when did the diagnosis

for PTSD & Depression ?

JMHO - carlie

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Carlie-

My SMR list PTSD and Depression under chronic illnesses. This was my diagnosis while active duty. My letter from VA states under reason for denial of PTSD/Depression:

Denial Reason: The evidence does not show a current diagnosed disability.

Expanation: We received your medical evidence from ********** **********, ********** ******, and *********** VA Medical Center, which discusses the symptoms of your medical condition. The examiner stated that you currently do not have a diagnosis of any mental disorders. There is no objective evidence of functional impairment found socially, occupational, or with activity of daily living due to a mental disorder.

I am not being treated currently, but I DO have symptoms. I have missed days of work and so much so that I was repremanded for it. (I told the C&P examiner this!!!)

My SC'd conditions according to my letter are as follows:

1) Migraines: 30% 2)TVT Sling: 20% 3)Mild dry eyes:0% 4) Allergic rhinitis:0% 5) Anemia:0% 6) Scar:0% 7) Restless leg syndrome bilaterally:0% Your overalll or combined rating is 40%. We do not add the individual percentages of each condition to determine youru combined rating. We use a combined rating table that considers the effect from the most serious to the least serious conditions.

Now there are no more sc'd conditions. It goes right into what was deferred for further C&P's. (Prolapsed bladder, cyctocele, rectocele)

However, In the second part of the packet it states: REASON FOR DECISION. Lists all of the above 7 SC'd conditions and why they rated as they did. THEN there is #8 SERVICE CONNECTION FOR ADJUSTMENT DISORDER WITH DEPRESED MOOD FOR THE PURPOSE OF ESTABLISHING ELIGIBILITY TO TREATMENT

It goes on to read: Service connection for adjustment disorder with depressed mood for the purpose of establishing eligibility to treatment.

A determination of service connection under 38 U.S.C. 1702 is for the purpose of providing eligibility for hospital and medical treatments f...

as I posted in 'Success" forum. This is why I am confused. It is not even listed under SC'd conditions in the break down. Not even listing it for 0%. However, in this part of the packet it is listed. So all I gather is they will treat me for it because I was diagnosed in the military (which should SC me as far as I know..at LEAST to 0% - right?) "Service connection for the purpose of establishing eligibility to treatment is established" -- isn't that what 0% means?

If so, why isn't this listed on the break down page under "Medical Description, Percent Assigned, Effective Date" ?

The VA I am located near has a 700 person waiting list. I was told "good luck", and they recommended I drive 2 hrs to the other VA which might have a shorter waiting list. I am going to start seeing a private psych. and get on some meds.

As for my migraines, I am not unhappy with my rating. I just wanted to be sure I wasn't simply rated for ocular migraines because I have classic migraine headaches and ocular migraines which are completely debilitating. However, like you said - I am sc'd properly, and I don't complain about that. None of the things I was "denied" for state they found no evidence to support them, just that they denied because I am not being treated currently. Like I said - not currently being treated for restless leg either, but they gave me 0% for that.

Thank you for your time. I hope I explained my confusion a little better....

Edited by AFMedic09

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Carlie is right-this needs to be developed more-

An inservice psychosis can be service connected as a chronic presumptive condition under 38 CFR 3.307 if all other conditions of the regulations are met.

But one of the conditions is that it must have been manifested at least at a 10% disabling level within the first year after service.

Did the VA specifically refer to any consideration of 38 CFR 3.307 in the decision?

Can you scan and attach the entire decision here (as to their reasons and basis) Cover the personal stuff first.

38 CFR 3.307 and 309 contain the info that might help you utilize this regulation to your advantage.

However many vets often need to obtain buddy statements as to their symptoms within that first year after service ,unless they have medical evidence within one year after discharge to warrant the regs to kick in as a presumptive chronic condition, which ';psychosis ' is, as found within the chronic disabilities listed in 38 CFR 3.309.

For example I was reading a POW claim award the other day.

The specific POW presumptives are within the above regs.

The veteran claimed frostbite residuals due to his interment at a POW camp,unheated in the dead of winter.

Buddy statements from his family members , as to his symptoms when he was liberated, as well as other medical evidence warranted the award for frostbite residuals.

On the other hand he tried to prove he had DMII due to nutritional deficiencies that are certainly problems POWs can develop that can affect the entire metabolism system.

His buddy statements on that part of his claim as well as a strong IMO didnt help him there.

I am trying t prepare a little more info on "buddy statements' to put here or maybe for a SVR show- as we often consider them to support stressors, but they can go a long way too ,in proving chronic presumptives in 38 CFR 3.307, 3.309 as well.

Do you have a vet rep helping you?

hey have already stated that:

"A psychosis/mental illness was first diagnosed on March 6, 2001 while you were on active uty".

IMO - this will need to be developed more and it's real important to see exactly everything

the decision states about it.

Edited by Berta

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AF, don't give up..They denied my PTSD 3 times saying there was no evidence of me currently having it..It took a years worth of clinical notes from a VA phsychiatrist stating that I had it plus attending therapy for me to get a new C&P exam....Shortly thereafter I was awarded 70% for PTSD........SO go to your VA primary care doc and request a mental health exam, then attend the therapy sessions...Once you have seen the shrink a few times get your notes and submit them.....I think that you really need to establish that you still have it.But remember that it has to be diagnosed by a VA mental health professional...................Good luck and keep trying......Grid

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Thank you Grid. My local VA has a 700 person waiting list, but I am not sure if that includes Mental Health treatment...I will call now and find out.

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I was diagnosed with PTSD and depression in the military. Was on Prozac and went through years of therapy sessions.

Like others have said you need to show this, but you need to address in your NOD the fact that the examiner did not address this fact.

An adequate exam is one that is based on a complete review of the veteran record.

Having more frequent bad days. I told the C&P dr. that I can't sit with my back to the door, I have had panic attacks due to boxes on side of road (WHO DOES THAT?!?!?!?!!!) etc.

Put this in the NOD and send in the copies of the dab boy reports from your job too.

The letter says they see where I was diagnosed with PTSD in the military, but that basically since I'm not being treated currently they wont SC. Not even 0%? But they sc'd for purposes of treatment. I don't know. I am going to start seeing a psych.

Mental health treatment is open to anyone free even if you are not SC.

I saw you had 30% for headaches too to get a 50% rating you need 2 or more per month that will require you to seek bed rest for a long time and a proof you lost time from work due to them.(income)

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Berta - I will try to cover and scan my entire letter so that you can see what I am talking about. Will try to do this on Saturday as I am working until tomorrow morning, and have to be back in at 4pm. Thank you for your time.

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Gulfvet45,

You posted,

"Mental health treatment is open to anyone free even if you are not SC."

In many situations I would be in disagreement with this.

Do you have a link to support the above?

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For a vet to get the benefit of the chronic psychosis manifested within one year of discharge you need to get you butt to the nearest VA and get evaluated and/or admitted. I was so dizzy that I actually went to the VAMC right after I was discharged to get some help. I got admitted and got zero help. However, it showed on my record that I was "treated" and "DX'ed" with a residual psychosis. I had no plan and it was all an accident. If I had waited two years to file my claim I would have been out of luck. Things were a lot different back in 1971, but still the best thing a vet can do is to go to the VA for complete physical upon discharge. This could mean the difference between SC and no SC. I got just 10% but based on that 30 years later I got TDIU.

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