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Filing and SMR questions

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HowIWish

Question

Let me start off with saying this:

I understand now how some might have thought when I asked my question about a hospitalization at the Va helping my husband get his disability I was trying to game the system or something. I didn't mean it that way at all. Back then (it feels like a lifetime ago) I saw my husband completely falling apart and I was being told by friends and family that he needed to be hospitalized. I saw it coming, and I was naive how the mental health system worked. My thought was that if he needed to be hospitalized anyway, that using the VA would help the situation in its entirety.

Yes, I was very wrong. I had read how amazing the VA's PTSD programs were, and I guess I figured getting him into the Va system then would sort of kill two birds with one stone. He could start getting help in a place he felt more comfortable by being around other vets, he could get the hospitalization he needed for much less than $2,000 a day (the price of the private hospital he had his outpatient care at) and he could go ahead and be in the VA system.

Well, if you've read my other posts you know nothing good came out of his 18 day stay at our local VAMC. It's been a nightmare ever since and keeps getting worse.

Sorry if I sound defensive. Being married to a man (whom I love very much) that has major paranoia issues has kind of made me this way. His paranoia tends to focus on me... I'm poisoning him, I'm holding him hostage, and on and on... Sometimes he has good days, and other days I spend most of my time trying to convince him I'm not working with Barrack Obama to have him put in a straight jacket. 

 

Anyway- on to my current questions! First, my husband's FDC was ready to file, we were just waiting for his SMRs. They finally came today and I was so excited. But there are NO medical records in the envelope. There is also no records pertaining to his deployment. It is basically just his enlistment paperwork, his security clearance paperwork, and his discharge papers.

On the ebenefits site where we put in his paperwork, it says the VA can get all of his medical records from DoD hospitals. Should we go ahead and file and let the VA get those records? The website says it can still be submitted as an FDC and they have access to those records. That's my first question.

My second question has to do with his ongoing care at the VAMC. This past week they told him he is now ineligible for all care and they canceled everything. They refuse to give us anything in writing, but they have canceled every single appointment he had, including his support groups. They say it's because he makes to much money. But he was already enrolled and paying co-pays! 

I've read everything I can find, and he is completely eligible for care. We were fine with paying the copays for now. The first week of February his income will be dropping by 2/3's, and then he was going to file a hardship and then they said we wouldn't have the copays anymore. 

We we really need to file his claim. The faster we file the faster (hopefully) he can be service connected and we won't have to worry about them cutting his Health benefits. Would you guys just go ahead and file now without the rest of the SMRs? There isn't going to be anything in there to really help a whole lo anyway. He didn't have any mental health issues while enlisted. Nothing became an issue until a little while after his discharge. His deployment was towards the end of his enlistment.

Also, what's the best way to fight them canceling his health benefits? The VA flagged him as a high suicide risk for 60 days of "Enhanced care," and now they're refusing him ALL care! It seems we should have something in writing so we can file an appeal, but nobody will even tell us who made this decision. This all happened yesterday, and this coming week is Christmas. I'm thinking we need to go to the VA in person Monday or Tuesday and get some explanations. 

One more thing- my husband had a PTSD screening because his outpatient psychologist was trying to get him into the 8 week inpatient PTSD program. While inpatient his psychiatrist said he did not have PTSD. That's a crock because every single professional he has seen outside of the VA has said he undoubtedly has PTSD and it is greatly complicating his other MH issues. But that does us no good with the VA. So he had this PTSD screening at the request of his VA psychologist who has been trying to get him further help within the VA. The PTSD screen doesn't say anything. He was denied getting into the program, and his psychologist told him that she has been told to make sure not to chart any diagnosis in his chart. It's just frustrating. Isn't the point of a PTSD screening to see if he has it? 

Oh well, forward we go! As always, any help is extremely appreciated. This site is invaluable. I have learned more here than anywhere else! 

 

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Berta, according to that rule Mike posted, the VA has to assume the stressor is related to his service since he has CIB. So can they even try to blame it on his police work? I know they really can do anything they want to, but wouldn't that be a CUE?

I'm still learning all of this from reading various posts!

He honestly hasn't had anything traumatic happen during his police work, just things that make him have flashbacks to Iraq. He was involved in some pretty nasty stuff in Iraq. I didn't even know how bad until he was in the hospital and a few of his combat buddies contacted me concerned about him. He had kept it all to himself, but they filled me in on how bad it really was and some of things my husband had to do. He was a machine gunner and had to kill some people that were shooting at them from rooftops more than once. I knew he had been shot at, but I didn't know he had killed anyone until recently. There's a lot more, but he had it pretty rough. It's stuff I wouldn't have made It through, that's for sure.

 

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 "I didn't even know how bad until he was in the hospital and a few of his combat buddies contacted me concerned about him. He had kept it all to himself, but they filled me in on how bad it really was and some of things my husband had to do. "

The VA apparently  cannot use his work as a cop against him.

Buddy statements from his combat buddies could go a long way in attempting to prove he has PTSD from combat.

There is info here on buddy statements,...under a hadit search..here is one I did: Just click on the blue title

 

I mentioned my daughter helping some vets in that one I think ,but maybe I forgot to mention...one of the buddy's shared his VA award letter with the other buddies...his stressor was based on the same incident and he had already received a PTSD award.

He wrote buddy letters for them all, and told the VA his PTSD rating and attached a copy of his award letter .

Buddy letters must reveal the buddy served same unit, time and place and contain details of the stressor ( also if the buddy himself has a PTSD award for same stressor that sure helps,) and give VA their full contact info.

We had a vet here with the CIB and VA said he didnt have PTSD either.

On the other hand I know many combat vets who do not have PTSD ( or maybe some do but dont want to claim it) but those vets do not exhibit the symptoms of PTSD as far as I can tell.

Sounds to me he is reluctant to talk about his combat experience-

(not unusual) and The buddies could do the 'talking' for him, and more than one buddy letter is always good to send to them to support a claim.

It might help VA to look at his situation differently....might....no one ever knows what the VA will do...having a good personnel record ,except for the stressors , as a police officer would show the police job exacerbated his PTSD....if they do diagnose PTSD -because of the buddy letters.

 

Edited by Berta
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No...His wife had asked us for help and many replied but she never returned.

It was probably more than two years ago.

 

 

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So, in your all' opinion, should I go ahead and submit the FDC without the rest of his SMRs? According to the VA website you don't have to submit VA medical records or SMRs, the can obtain them and it doesn't change you status of filing FDC. 

And since his DD214 has CIB, in theory they should presume PTSD caused by combats anyway. 

Or should I keep trying to get the rest of his SMRs? If our financial situation wasn't so critical I would just wait. But even getting a smaller rating right now would help so much, and then we could go for a higher rating. But at the same time, I don't want to screw this all up and get nothing and take years on an appeal.

I know nothing is guaranteed, but I've done more than my due diligence and he definitely meets all the criteria under PTSD/ mental illness, and OSA as well. 

Thanks for your input!

 

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