EED CUE?

[Billielea]

I have asked if this is CUE on here before, but I have since received my C-file and am able to upload my C&P exams. I was initially denied PTSD in 2009. I was awarded 50% in 2015. I have filed a NOD on the rating and effective date last month and made inquiries to a lawyer to handle my claim. The problem is it doesn't seem like CUE to me as I understand the definition. I was diagnosed with adjustment order in 2009 and then PTSD in 2015. The main reason I would like to try for an EED is the last paragraph of the 2015 C&P exam where the Dr. states:

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

Both C&P exams are attached. Any thoughts?

2009 C&P exam notes2.pdf

2015 - C&P exam Notes.pdf

[Buck52]

I believe  a veteran only needs to meet 3  diagnostic criteria?  not all 5

so I agree with Ms berta All diagnostic criteria has to be met  is B.S.

BUT I'M GOING WITH THE 2010 CHANGE.

I would think the new regulations on PTSD would be grandfather in.  IF SO then the EED would start in 2O10.\here is a link o the new 2010 update PTSD Regulations, be sure and read all the way down and check out the last line in #12...so I don't think a CUE can be beneficial here?

http://www.veteranstoday.com/2010/07/12/new-regs-on-ptsd-claims-facts-and-qa/

The new regulation will not change the diagnostic elements of the C&P interview, but may change what additional data are collected for use by VBA raters.

 

jmo

...........................Buck

Edited July 24, 2016 by Buck52

[Buck52]

Based on the new PTSD regulation  in my opinion no CUE, but there maybe a CUE in an older 2015 decision has Ms Berta Points out as the c&p examiner gave good evidence  for better EED  if I understand it?

Depending on how bad you need  the EED,? if your ok financially wise   then I'd agree with the 2010 decision..if it was the correct rating?

Edited July 24, 2016 by Buck52

[Berta]

The new PTSD criteria was used for the 2015 award Buck.

The problem is with the bogus denial and diagnosis in 2009.

The DSM used in 2009 is incorporated into this BVA decision as to how PTSD is to be rated. No where does it say 'ALL diagnostic criteria ' must be met for a PTSD diagnosis.

And I didnt even see any GAF in the 2009 denial---will check that again...

This veteran has the CAR and obvious stressors. She has PTSD diagnosed and compensated now (because the C & P examiner could read and assess her properly )and she didn't get PTSD overnight.She is a combat veteran.

The EED for the PTSD award is what she is fighting for.

I dont get it.

I see no evidence that they gave her, in 2009, any MMPI test or even determine a GAF.

The problem for a CUE claim is that all MHs have the same Diagnostic code so there is no error to call them on in that respect..

I didnt see any NSC rating for the wrong diagnosis either......

Still...I will try to figure out if she could file a CUE on the older decision, in case the NOD does not resolve the EED.

 

 

 

 

 

 

http://www.va.gov/vetapp10/files2/1013383.txt

In Part:

The schedular criteria, effective as of November 7, 1996,

incorporate the American Psychiatric Association's Diagnostic

and Statistical Manual of Mental Disorders, Fourth Edition

(DSM-IV).  38 C.F.R. §§ 4.125, 4.130 (2009).  A rating of 30

percent is warranted for PTSD if there is occupational and

social impairment with occasional decrease in work efficiency

and intermittent periods of inability to perform occupational

tasks (although generally functioning satisfactorily, with

routine behavior, self-care, and conversation normal), due to

such symptoms as: depressed mood, anxiety, suspiciousness,

panic attacks (weekly or less often), chronic sleep

impairment, or mild memory loss (such as forgetting names,

directions, recent events).  38 C.F.R. § 4.130, Diagnostic

Code 9411.

 

A 50 percent rating is warranted if it is productive of

occupational and social impairment with reduced reliability

and productivity due to such symptoms as: flattened affect;

circumstantial, circumlocutory, or stereotyped speech; panic

attacks more than once a week; difficulty in understanding

complex commands; impairment of short- and long-term memory

(e.g., retention of only highly learned material, forgetting

to compete tasks); impaired judgment; impaired abstract

thinking; disturbances of motivation and mood; difficulty in

establishing and maintaining effective work and social

relationships.  Id.

 

A 70 percent rating, may be assigned for occupational and

social impairment, with deficiencies in most areas, such as

work, school, family relations, judgment, thinking, or mood,

due to such symptoms as: suicidal ideation; obsessional

rituals which interfere with routine activities; speech

intermittently illogical, obscure, or irrelevant; near-

continuous panic or depression affecting the ability to

function independently, appropriately and effectively;

impaired impulse control (such as unprovoked irritability

with periods of violence); spatial disorientation; neglect of

personal appearance and hygiene; difficulty in adapting to

stressful circumstances (including work or a work-like

setting); and inability to establish and maintain effective

relationships.  Id.  The criteria for a 70 percent rating are

met if there are deficiencies in most of the areas of work,

school, family relations, judgment, thinking, and mood. 

Bowling v. Principi, 15 Vet. App. 1, 11-14 (2001).

 

A 100 percent schedular evaluation contemplates total

occupational and social impairment, due to such 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

(including maintenance of minimal personal hygiene);

disorientation to time or place; memory loss for names of

close relatives, own occupation, or own name.  38 C.F.R.

4.130, Diagnostic Code 9411.

 

In assessing the evidence of record, it is important to note

that the Global Assessment of Functioning (GAF) score is a

[Berta]

I dont know if this regulation can be incorporated into CUE... will do more research and try to find more.

It really isnt a change in diagnosis it is a 'reconciliation" of what the 2009 diagnosis should have been all along.

 

 

§4.13  Effect of change of diagnosis.

 

                The repercussion upon a current rating of service connection when change is made of a previously assigned diagnosis or etiology must be kept in mind. The aim should be the reconciliation and continuance of the diagnosis or etiology upon which service connection for the disability had been granted. The relevant principle enunciated in §4.125, entitled “Diagnosis of mental disorders,” should have careful attention in this connection. When any change in evaluation is to be made, the rating agency should assure itself that there has been an actual change in the conditions, for better or worse, and not merely a difference in thoroughness of the examination or in use of descriptive terms. This will not, of course, preclude the correction of erroneous ratings, nor will it preclude assignment of a rating in conformity with §4.7.

 

                [29 FR 6718, May 22, 1964, as amended at 61 FR 52700, Oct. 8, 1996]

 

                Supplement Highlights reference:  19(1)

[Buck52]

they say'' The evidence does not show a confirmed diagnosis of posttraumatic stress disorder which would permit a finding of service connection.  “

 

“A diagnosis of post-traumatic stress disorder must meet all diagnostic criteria as stated in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association. The evidence does not show a confirmed diagnosis of posttraumatic stress disorder which would permit a finding of service connection.  “

This is pertaining to the old Regulation, but she has her stressors and CAR..Ok  under the new 2010 PTSD Regs  a veteran must state in lay testimony  he/she was in enemy hostile territory in fear for her life  for a stressor   ...but what confuses me is  if she is a combat veteran  the records should show that  on DD-214 combat pay records and her CAR. Morning unit reports...I mean if that's not proof enough whats a veteran to do?

I proved my stressors withDD-214 Lay testimony of where and when I was in Hostile enemy territory in fear of my life when the events occurred...with mostly my service records from VietNam.

If she has records placing her in Hostile Enemy Territory in fear for her life  that's all she needs   in my opinion. for stressors

Has this veteran been SERVICE CONNECTED &  VA Diagnosed for PTSD DSM-5 ?

 

[Billielea]

Berta, Thank you for the work you are doing to figure this out.

Buck, Yes I was SC 50% for PTSD in 2015. I did file a NOD for the EED last month.