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Is This A Success Story? Need Some Advice...

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NJ_Devil_Dog

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Guest frank
I just received my rating for SC PTSD, they rated me 30%, stating that I had a GAF score of 50, with 55-60 assigned for the last twelve months. I've only recently started seeing a VA psychologist in the past five months and I obtained a copy of my first progress note from our first session and he rated me with a GAF of 41. During my next appointment with him he told me that he gave me the GAF of 41 because he was worried that if he had rated me any lower his supervisor would've questioned him why I wasn't admitted for care at the facility.

I am a full time student, however in the past year since returning from Afghanistan I have not been able to complete not even one semester at school. To make a long story short, I believe that I meet the qualifications for a higher rating. My question is: How typical is it for the VA raters to 'low-ball' awards decisions?

Here's the second part of my story. I am a 're-tread', having served in the Marine Corps from '87-'92, and then reenlisting in 2001 with the National Guard. I was awarded the CAR during the Gulf War, and had already been denied my original claim from '95. The claims award I just received was from that re-opened claim for which I had to submit new and material evidence.

In my original denial letter dated May 03, 1995, the evidence they reviewed making the original decision was only my SMRs and they stated that I failed to report for a C&P exam (which I clearly remember reporting for!) However in the recent decision the evidence they reviewed included my recent C&P exam, my stressor letter, current treatment records, my DD214 & 215, and 'mysteriously' my VA treatment records for the time period between July '92-June '96!!!!!

I realize that I was pretty naive back then, after I had seperated from active duty, but I was diagnosed with PTSD well within a year of my release date (more like less than 6 months of my release date!) I guess that my original denial in '95 more or less gave me a false reassurance that there was nothing wrong with me, in retrospect I know better. I've never held a job for longer than 18 months, I bounced around from at least ten jobs in the eight years following my seperation from the Marines and I've even been fired from three of those jobs for incidents that could be directly related to my PTSD/stress!

I'm doing a little bit better now, but I can tell when I miss taking my medication, even if it's only one day! I feel like the 30% rating is an insult!!!! I intend to file an NOD to have it adjusted, I also intend to file a CUE for the original denial! I would appreciate anyones input on how I should proceed... should I file for the increase first? The CUE first? Or can I do them at the same time? Also, could my PTSD diagnosis in '92 constitute an informal claim? What or wheremy behalf if yours won;t do this for you as for another Phychologist

I have the same problem I see a phychologist that is great . request another phycologist he doesn;t seem helpful. my dr writes letters fom me to va today she is sending another letter. with her help i got 100% ptsd. I also had ia exam did not show up for exam; by dumb luck i went through the ee-z pass I do not have a psss; so they took a picture of my plate time and date so i had proof i went to va i live in nj as well i go up the parkway when you go to va if you go to east orange take the eazy pass exit for sure you'll proof because you will get a 25.00 find you can always appesl..va has a fax number i would like you to have 973-297-3314 claims supervistor phone number. MIKE BLAZIS 973-297-3233
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Thanks Toimi and Frank,

It's been a while since I've checked back in with Hadit; I've been busy with school (failingly for the most part, I was just informed that I was facing an academic suspension for doing so poorly, but one of my professers stuck up for me and I'll be able to continue with my classes!)

I have been back to the VA and now I have a new therapist that I'm looking forward to working with. I'm still working on my claim, but I think that I'm going to go it alone without the help of a SO. The one I have isn't helping me with my concerns. He won't NOD my CUE claim for a retro decision to the '95 PTSD claim that I filed (an unfortunately never appealed; I wasn't as savvy back then).

Here's what troubles me about that original ('95) claim. The original claim stated that my SMRs were the only evidence reviewed, plus VA claimed I failed to show for the C&P exam. (I previously mentioned this, as well as stating that I DID show for the exam)

Now when I recently received my SOC, the VA states that in the original claim the evidence considered was the "examination of May 31, 2006" ---- THE DATES DON'T ADD UP!!!! I was claiming CUE for the '95 denial, now they're saying they originally reviewed records from '96?!?!?! Does the VA have a time machime or something? I never had any exam in that time period except for the '95 C&P exam that they claim I missed!

Maybe someone out there can give me some advice.

Sincerely Gerald

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Regardless of what your SO said-I hope you still are within year to NOD the CUE denial.

You made excellent points here as to how to state the NOD-

it seems like this is a great point- ------DUH!-I see what you mean----

"I was claiming CUE for the '95 denial, now they're saying they originally reviewed records from '96?!?!?! Does the VA have a time machime or something?"

This seems to contradict the reason for the denial-

also I would fully support the fact that you were at the C & P with copies of any evidence you have-

Gerald -If I were you I would write to this VAMC where that 1995 C & P occurred and ask for a copy of it- that is proof you had it as well-

Also- forget ---did you say you had copy of your c file ? One of the best things a vet can do is get a complete copy of their c file-it is free- just write to the Records Access Officer of your VARO.

Of course this means they will pull it out of the queue. But the time that takes can be invaluable when you see it-

that older 1995 C & P report might even be in it.

I would respond to each point of their denial with copies of attached evidence and make the point that the 1996 'original review of records' as to the SMRs occurred in 1995 and this is not consistent with the original denial.

maybe I said that wrong- but I get what you mean-

They have to be told these points like they are 12 years old.

I hope you haven't had any Voc Rehab problems-

with the stipend and stuff-

they messed up my kid's and my own Chapter 35 right away but reversed in 3 weeks for both os us-upon receipt of our very strongly worded NODs which had the evidence attached to them- AGAIN.Which they had anyhow-

My kid cursed like a trooper when she got the first Chap 35 letter- they awarded one month of edu benefits-

but due to her mil service they owed her one month and seven years!

She had sent the DD214, the regs- everything they needed- but look -

if the VA can get away with wrong entitlement dates or wrong reasons for denial and the vet accepts that-

the VA saves money.(but what they save it for is beynd me, it belongs to veterans)

I say NOD anything that doesn't seem right or file a CUE if the year NOD time frame has passed.

Edited by Berta
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Thanks Berta,

I'm still within the 1 year to NOD the '05 decision and the decision to change to 50%. My VSO doesn't seem too enthusisastic about pressing the CUE claim though.... So I'm dropping him like a bad habit! Even when I showed him how the dates didn't add up, he just said, "Well that could've just been a letter they sent you..." (referring to the '96 business in the SOC)

I haven't received my c-file even though I requested it shortly after I filed to reopen my claim in '05..... I think I'll request it again.

Berta, could you please have a look at my most recent post :

http://www.hadit.com/forums/index.php?showtopic=4469&hl=

You really seem to have you act together and I would appreciate the input. I read the USCs and the CFRs pertaining to these topics but sometimes the legaleeze gets pretty confusing.

One last thing, I have gone through the VA to get my outpatient records from Lyons VAMC, New Jersey, but all they ever send me is the inpatient records from an unrelated operation I had at the East Orange VAMC, New Jersey......

Thanks for all your help,

Gerald

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I had problems with Lyons and NY VAMC in Newark too-

No record of this or that-at least that is what this VARO here said (Buffalo NY)

But my husband's SSA files contained all the New Jersey stuff- even though this VARO stated it did not exist. Have you tried to call their FOIA officer-they should process your request-

(PS-I worked as volunteer at the Trenton Vet Center in the 1980s-and my VA card and background check went through Lyons-I don't see much NJers here these days)

I thought I did respond to your other post-

will check it out-

I just remembered something- if these are vet center records- they might be at the vet center and not the Lyons Hosp-???

Edited by Berta
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Thanks for the insight Berta,

I think I may try to go directly through Lyons and East Orange, however; I now live in Arizona so I might wait and see if I get anything pertinent with my c-file (whenever that gets here....)

Am I right when you said that your husband's files from the SSA had all the info? I just recently applied for SSDI, will I have access to the records they obtain as well (even though most, if not all of it will come from the VA)?

None of the records are from the Vet Center until recently. I was seen there for a few sessions and then they reffered me back to the VA for some reason or another.

Hopefully I'll start getting some more records to substantiate my claim. Until then I must thank you all for the helpful advice.

Sincerely,

Gerald

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