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How to Get your VA C-File


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    • Should I file a claim now or wait?
      Thanks Gastone, I have not started the claim on E-ben yet.  I'm still getting all my evidence in order.  I never filed on E-ben before I assume you can do a FDC on there just like filing at VSO.  
    • PTSD Denied NSC - Schizophrenia NSC
      Hi Mark, Thank you so much for responding.   He does not have a current treating psychiatrist.   Following a 1978 suicide attempt and subsequent hospitalization at a psych ward for 30 days - the psych ward doctor issued a diagnosis of schizophrenia - paranoid type.  After some bizarre behavior by my brother in years that followed, he was an outpatient treatment at county mental health center on and off and attending physician wrote diagnosis in 1983 of " schizophreniform episode with depressive symptoms" .  This medical evidence was submitted with his original claim in 1982 and his request to re-open claim in 2015.  He was not treated for any mental illness while in service / Vietnam.   At his recent C&P exam (last month) the attending VA examiner diagnosed him as still being schizophrenic and they issued a 50% rating -- but the rating indicates NSC. I will request a copy of his C&P exam from last month immediately -- thank you for pointing me to the form.  I have contacted several psychiatrists in the area to examine him and complete a "DBQ" to show nexus to his Vietnam trauma and they won't even return my calls.   My personal opinion as his sibling (I'm a former banker - certainly not a doctor) is that immediately upon return from Vietnam he had PTSD (burning his uniform, anti-social, startled behavior, etc) and this evolved into schizophrenia, culminating with a suicide attempt. Symptoms are still there -- just under the surface - because I take care of everything for him down to covering his rent shortage, co-signing for his apartment, buying his clothes and (meager) furnishings, etc.      
    • Question about NOD wait time after applying.
      Pack a lunch. DRO Reviews anywhere 12 - 18 months, DRO Hearings 2+ yrs, mine took 4.25 yrs in 2014. Check your RO's, most recent, Monday Morning Report. Unless it's changed, the MMR will show the "Total Appeals" pending for your RO. It doesn't list the DRO's separately from the BVA's. Gives you some idea of what your into. Call any of the VSO's that have an office at your RO, try to get the MFIC or a Sr Service Rep on the line. Find out how many DRO's are on your RO's Staff. He should be able to find out exactly how many pending DRO Hearings have been handled in 2016. From there you can do the math. Keep in mind, you MUST submit the "New & Material Evidence," Mandated by the VA Reg for a DRO Review or Hearing.  Early receipt of your N&M Evidence, could trigger the VA Automatic Review of your Denial by a Sr Rater or actual DRO. You "could?" get an award or a Continued Denial, much sooner than the actual DRO Hearing.  FAILURE to submit the N & M Evidence, will guarantee you an Administrative Denial. At the 4 yr mark, I filed an Official Request for an "Informal DRO Evidence Conference." Never got the conference, but within 3 months I received the VA notification that my DRO Hearing was on deck for 6/28/14. I chose to go "Informal," no recording transcription. Hearing lasted 35 min, DRO told me he was awarding everything. I was out of the RO by 930am. VSO Rep had a copy of the DRO Award by 3:30 same day. Retro hit mid July, VA Award Letter, like Aug 1. It's not unusual for the DRO's Decision, to take up to a yr after a Regular (not informal) DRO Hearing. Semper Fi
    • Question about NOD wait time after applying.
      The best way to figure out where you stand with your NOD is to follow the VA Monday reports. Look up your Waco RO and click on the TA tab all the on the right side. It will tell you how many appeals your RO has waiting. Follow the reports for a month and you will get a general number of how many NODs the RO is completing. Even this is not a guarantee or totally accurate. Example: My brother in law in Connecticut had his DRO review done in 28 days. A friend of mine out of the Tampa St Pete RO has been waiting 2 1/2 years. The VA says the average is 377 days. I figure 12 to 18 months is the average. I am out of the NY RO. I figure two years for DRO review and then tag on another three years if it goes to the BVA judge. Good luck with your appeal!
    • PTSD Denied NSC - Schizophrenia NSC
      What diagnosis does his current treating psychiatrist list? How about mental health treatment in the past--did they diagnose schizophrenia? PTSD?  When did he first manifest symptoms of schizophrenia? When did he first receive treatment for schizophrenia? Sorry to ask so many questions, but that information will help me and others to give you more specific advice.  I agree with @Berta - you have a right to receive a copy of the C&P exam reports from VBA after the Rating Decision. Use VA FORM 3288 and either mail or fax it to the VBA Centralized Intake Center. If you mail it, do so in a way that gives you proof that it was received, e.g., U.S. Postal Service Signature Confirmation. If you fax the form, you will receive a fax receipt from the VBA centralized intake center. I attached a copy of VA FORM 3288 with some tips for how to fill it out. You can complete the form by printing it and then filling it out with a pen, or you can type your answers into the form, and then print it. Be sure to sign and date the form in ink. VA FORM 3288 is online at: http://www.va.gov/vaforms/va/pdf/VA3288.pdf All the Best, Mark VA3288-Request-for-Records-use-for-C-file_Requests.pdf
    • Tbird in Chatroom Now - Mon May 30 NOW - Join the Chat 
      Tbird in Chatroom Now - Mon May 30 NOW - Join the Chat 
    • Question about NOD wait time after applying.
      When you file a NOD how long does it generally take on the average to hear back from a DRO?. I filed a NOD form last week with Waco, TX. Regional Office and also asked for a DRO Hearing right up front to get that part out of the way without further delays asking me what kind of DRO I wanted...  Never done a NOD before so any input on average time frame of initial response is helpful.  Just curious. Wayne.
    • PTSD Denied NSC - Schizophrenia NSC
      "Furthermore, they made no mention of Agent Orange disabilities claimed (hypertension, ischemic heart disease, etc) even after I responded to 8 of their questions on this disability." Sorry I missed that at first...they properly developed the 5103 waiver as far as I can tell. The vet rep will want to see a copy of that and how you responded to it.  The 40 % GSW rating is for what would obviously be a stressor. There must be something in the original denial that they would not re-open the PTSD claim for. The Vet rep might well use this 40% rating as New and Material to the PTSD claim.... Your statements would be good as to symptomatology, but long standing serious symptoms have to  lead to documented medical care. I concerns me that they did not defer the AO issue, but simply seemed to ignored it.      
    • PTSD Denied NSC - Schizophrenia NSC
      Were any AO disabilities claimed on the 21-526 form? "I need to get an expert involved for our NOD and a new claim for Agent Orange since they completely overlooked that -- A rep at American Legion wants to take it on.   Do I go this route or go to an attorney?" I would let a rep look it over first. "Will QTC give me a copy of his exam? " The VARO should be willing to release it to you with a formal request for it.   "I need to get him another dr exam to show evidence of his current Agent Orange symptoms"   Did the 5103 waiver or anything else from the VA  ask for more specific medical evidence of any claimed AO disabilities? There were many personal statements from you in the evidence list. VA often breezes over statements like that in favor of concentrating on any established medical evidence, such as formal diagnosis and treatment records.. I think you had mentioned here before that he had heart disease. Did they have any medical evidence to that affect?  
    • Finally got my 100% for Malignant melanoma
      Great News - Happy you got your rating. Take care of yourself.

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PvtJoyI

Surprise 70% Ptsd Rating; Now What Can I Do.............?!

20 posts in this topic

I hope you can help me; not sure what I should do.
I was rated Service Connected Disable for PTSD on August 21, 2012 @ 70%. I didn't expect this at all. If anything, I thought I would get a low rating for my physical aliments............(neck, back head shoulder).
When I applied in 11/2011, I had been out of work for 3 yrs and was totally distraught,confused and disoriented. Needless to say, I finally got a job in 02/12 and it is no where near what I use to do or the money I use to make.
I'd like to know what your advice would be for this:
I see where I do have serious social and economic problems and believe I am totally diasable & want to ask for 100% PTSD, Permanent and Total. I'm still on this job that wrecks my nerves, can't stop the obsessive thoughts and wants to hurt people because I don't work well with people at all. I took this week off because I couldn't pull up the gumption to go back in there after the week, mentally.
What should I do; appeal my rating 1st and then apply for TDIU while working or do I go ahead and let the job go in order to apply for TDUI and then appeal the VA's decision?
Thanks in advance.

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The reason you didnt get 100 percent or IU was the fact you we were working.

100 percent PTSD precludes working.

Dont quit to get IU just yet. That may backfire.

J

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Big factor on why you didn't receive 100% for PTSD as JBASSER had stated, your working. You can request a re-evaluation, but based on what you said above, I believe your 70% would be lowered. You stated you been out of work for awhile. Since that evaluation, you have secured employment.

I just hope that you are receiving the counseling that you are entitled to.

Good luck!

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What did they say about TDIU?? With a 70% rating they should have considered it, automatically. Can you post their "reasons and bases" for there decision??

pr

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“I finally got a job in 02/12 and it is no where near what I use to do or the money I use to make. “

Do you make wages below the poverty level and therefore are not substantially employed?

This post shows what I mean

“. If anything, I thought I would get a low rating for my physical aliments............(neck, back head shoulder). “

Did they defer these issues or mention them at all in the decision?

Do you have a strong service nexus for any of these issues in your SMRs?

What is the prime disability of the neck,back ,head, shoulders and what are you claiming as secondary?

Or are they distinctly separate disabilities?

Reason I ask is that this stuf has to be carefully clarified for the VA in the claim.

Edited by Berta

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Thanks for the input.

Here's my break down:

SC for PTSD @ 70 %

Service Connection for PTSD and Opid abuse(claimed as chronic depression, annxiety, panic attacks and sleep disorder.

We have assigned a 70% evaluation for your PTSD and Opid abuse based on: Speech intermittently illogical & irrevelent; The examiner's assessment of your current mental functioning, which is partially reflected in your GAF score;

Your GAF score is 60. No mention of UI.

"A higher evaluation of 100%is not warranted unles there is total occupational and socail impairment, due to symptoms as:Gross impairment in thought processes or communication;Persistent delusions or hallucinations;Grossly inappropriate behavior;Persistent danger of hurting self or others;Intermittent inability to perform activities of daily living;Disorientation to time or place, memory loss for names of close relatives, own occupation, or own name.

SC for Right Shoulder Tendonitis @10%

SC for Cervical Spine Degenerative Changes @10%

"A higher evaluation of 20% is not warranted unless there is foward flexion of the cervical spine greater than 15 degrees".

SC for Lumbar Spine Strain @10%

"A higher evaluation of 20% is not warranted unless there is foward flexion of the thoracolumbar spine greater than 30 degrees".

I am going to mental health. I'm getting some sleep but haven't started talking about my issues:gang raped @ induction site, married for security and that turned out abusive, can't have kids behind STD from rape, never completeing any goal I set, always failing, haunted by service to my country, some delusion and definie memory loss; no relationship in over 10 yrs including no sexual activity; rarely deal with people.

I just went to a VSO and he said that I don't need to appeal the decision because they gave me a rating. If anything, submit medical evidence to support a request in increase of %'s.; don't file for UI unless I'm not working; should I quit the job, but sure to stay that it was due to complication of my PTSD; Don't go for an appeal because it takes 5 yrs for a decision.

What else can I say................................I'm really torn and confused and don't know what to do.

All Input Welcomed and Thanks!

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I'm still on this job that wrecks my nerves,

You are not alone, I promise you.

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Understand that with PTSD.. getting a job was never the problem.. Keeping the job was..

Not sure what your relationship is with family but it helped my case to have my wife write a letter showing how my mental illness effected all parts of my life such as not able to care for our children when depressed because I can not care for myself.

The VA acknowledge that she was not a medical expert but did contribute as a witness to my state of mind. She wrote a letter describing me as my condition on the worst day possible.

Too often we want to appear strong and able even though it can hurt us. It helps to have someone work with you who knows you on the best of days and the worst of days who can describe it in detail.

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I just went to a VSO and he said that I don't need to appeal the decision because they gave me a rating. If anything, submit medical evidence to support a request in increase of %'s.; don't file for UI unless I'm not working; should I quit the job, but sure to stay that it was due to complication of my PTSD; Don't go for an appeal because it takes 5 yrs for a decision.

What else can I say................................I'm really torn and confused and don't know what to do.

All Input Welcomed and Thanks!

I agree with the VSO.

JMHO

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I disagree with the VSO. If you dispute the rating%, then file a NOD. Simply asking for an increase without a NOD, could result in an increase, but at a later effective date. Whenever you can, preserve your effective date, assuming you feel that you are entitled to 100% at an earlier date. Your effective date determines your retro. You know much more about your work/medical history than we do, and you know more about it than your VSO.

If your employment is "marginal" then you still qualify for IU. Marginal employment means you earn under the poverty level in a 12 month period. The poverty level is about 10k per year. So, if you have earned under 10k in the past 12 months, you can apply for IU. IU means you are unable to maintain substantial gainful employment, and marginal employment does not count.

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does your primary care or shrink support your stopping work? without their support your claim is not going to go very far, you need the medcial evidence and medical support yo get the rater to support it, and frankly I have to say you are the first person I have even seen get 70% with a GAF score of 60 we all know GAF scores are a snapshot and they can vary from hour to hour but in a C&P exam that appears to be high for a rating of 70.

the NOD can or BVA appeal can take a year to 4 or 5 years right now there is nothing easy about it if you have a spouse and kids are they covered by health insurance where you work now, if you quit what are they going to do for health care until your appeal is granted if it is granted? It's your choice but it can get a better award or it can make things worse there are no guarantees

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Thank you for all the feed back.

Here's the latest update. Meds have been a big help with dealing with the job, although I still want to leave it. Got my C-file from regional office. Un be lieve able~!~!~

Physical aliments are still painful and one of the Dr's on my primary care team told me to talk to my psych for an adjustment in my meds, as if the pain is all in my mind.

The medical records clearly reference sick call for back, knees, stomach and others area determined, "No evidence of".

I have until the end of June to submit my NOD. I would appreciate all input again on the best way to write the notice. I know that I will be submitting new medical evidence.....oh by the way. I forgot to mention that I requested my SMR from St.Louis and they sent me 2 pages!(unreal) my VA file has all the information I need to substantiate the claims that weren't given service connection.

So I plan on taking each section denied and will add each medical reference to denied claim so that the DRO reading it, won't have to figure it out; it will be laid out in such a manner that even Forrest Gump would say, "this is Service Connected".

One more question; can I request a 2nd C&P because I did what the examiner said to do and she said I had full ROM but did not annotate the pain it inflected.

Oh; one more thought, reading my personnel file, I can see why they easily rated me @ 70% because I was a documented threat to my self and others on too many occasions...................it hurt to read & remember some of the instances.

Well, thanks for reading this and I look forward to any and all information, suggestions and personal experiences.

PS Does anyone have experience with a "Fully Developed Claim". I need to submitted another claim for items listed in my SMR that I can ask for SC because they are problematic. I don't trust my VSR because once she found out I got my retro, she said, "I'm looking for a very nice card from you", implying that she wants a monetary gift. That turned my stomach............

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Whatever organization your VSO works for would receive a serious letter of complaint, if it were me. In fact I might complain to the VAOIG's office, about it. jmo

pr

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I agree with PR, you should contact someone about the inquisition, she was wrong in each and every way!

A fully developed claim is submitted on a VA FM 21-526ez. You will need to enclose all medical documentation concerning the disability you want to claim and send it to the VARO in your state.

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Does your job include some kind of disability retirement? Your rating does not make sense to me. 60 GAF is usually the number you get for a 30% rating. Maybe wait until you get fired and then file for TDIU or 100%. I was fired from long term job when I filed for TDIU. I was rated at just 30%. When I lost my job I asked for the increase and got 70% but was still turned down for TDIU. It took me another 8-10 months to get TDIU. By that time I had SSD and disability retirement from my job. If you have a mental disability having a job is poison for getting a high rating at the VA. What is your combined rating for physical and mental disabilites? May I ask your age? This does not supposed to have an effect on getting TDIU, but do you want to be 100% unemployable for 40 years perhaps?

My intermediate advice is to complain a lot and never say you feel OK.

John

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Hi and thanks for the responses.

I'll be 49 in July and my job is with a contracting co for a big corporation. I haven't applied for TDIU nor SSID; I don't know how to quit a job.

The PTSD rating is the only %'s I have; they gave me nothing for my back, hand knees, should or lost reproductive organs.

I am learning not to say I'm ok very day when I'm not..............so I'll keep trying to deal although I guess the meds are helping me deal with the stress & pressure of the job.

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Check your PM, OK?

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"Personal" or "Private Message".... It is the little envelope icon located to the left of your name @ the top of the screen where you sign in and out. Just click on the envelope icon.

Edited by #1Cavtrooper

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Senior  or Pvt, I know it has been awhile since this post, but any chance either of you still check this? Sorry- new to this and this topic hits home here.

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