ptsd C&p Exam Results Vs. Raters Decision

[Tiki]

Hi all and thanks so much fro being here for us. Spent my time in the USAF 67-68 at the Dong Ha Marine Combat Base 6 miles from the DMZ.

Just received a copy of my C&P for PTSD from Mar '09. It states - Axis 1: PTSD - Axis 5: GAF 55. On pg. 15 it asks: IS THERE TOTAL OCCUPATIONAL AND SOCIAL IMPAIRMENT DUE TO MENTAL DISORDER SIGNS AND SYMPTOMS ? ANS: yes.

Then the narrative below says:

"Veteran becomes hypervigilant and experiences flashbacks in the presence of people and is afraid of going out from fear of getting these symptoms he does not go out to socialise with people, stays home, gave up leisure activities, isolates himself and stays home mostly. He cannot experience loving feelings, cannot feel close to people, has been living alone for many years and isolates himself from others. His occupational and psychosocial status are impaired by his PTSD symptoms."

Also, any info in that opinion came from the VA Social Worker Counselor and the VA Psychiatrist that I have been seeing. I know this because the C&P exam lasted 10 minutes and the DR. really didn't want to hear anything saying " I have all the info I need here already." He was pointing to my C-File.

After talking with others, they tell me language was similar (Total Impairment) in the C&P Report they received and yet they got ratings as low as 30%.

My question is: Is it common to use that language (total impairment) and still come out with a lower rating than a vet deserves? And how can a Rater's opinion trump a Psychiatrist's opinion who has been seeing you for months, and if it does isn't it obvious that a higher authority will overrule the rater on appeal?

[WHOLESALE]

I wish we could cook like that Carly but unfortunately the eggs are in VA's pan..

frank

Just like cookin' in the kitchen.

This is a fairly standard VBA recipe ~ lol.

carlie

[Tiki]

Tiki

That sounds like a good claim for IU. However, the rater can overrule a C&P exam. The VA often just goes with the C&P, but if they want to be nasty they can impeach their own doctor. Is your PTSD stressor verified? I assume it is if you got a C&P exam, but that verification is what usually screws up PTSD claims. I bet you get IU, but you won't know until you get the rating letter. Don't start spending the money yet. The VA can do anything and that is why we have appeals. Don't blow your stack if they find some excuse to slow you down. Your train is on the tracks, but the VA can put on the brakes.

Thanks John

Re the stressor, I had no problem. We were shelled frequently from NVA artillery. Lots of bad stuff and they never questioned it; plus a Purple Heart (him not me) buddy letter. Also still have prostate cancer residuals after recent removal. They just notified me that I got 40% pending radiation treatment.

[Tiki]

Also, if that is verbatim what the C&P doc wrote, that doc needs some basic grammar lessons...besides the fact that the statement was generic, it was badly worded generic.

It was verbatim, warts and all. You should see the rest of it. I couldn't believe a professional of any kind would be party to such a piece of junk. He must have just had someone with low skills compose the whole report from the notes of the VA mental health professionals who had been treating me because he didn't spend 10 minutes with me.

[Berta]

GOOD -40% Congrats -but not good to have the prostate problem. hwever they can change the ratings as prostate cancer does usually have a good outcome with good affective treatment- they rate residuals such as in this recent BVA decision for prostate cancer:

http://www.va.gov/vetapp09/files1/0904039.txt

I assume this is from your exposure to the AO.

Did they pay the proper retro?

Did you ever claim this before and they denied the claim?

Reason I ask is the Nehmer decision and court order-

Many vets denied for SC disabilities in the past, after Nehmer Court Order, found they had disabilities on the AO list and could get retro back to the original claim even if denied and never appealed.

That depends on many factors too involved to post here but all in the Nehmer COurt Order and Stipulation at the NVLSP web site.

In April my husband became an official AO vet- death due to AO.

The retro EED for my DIC- 14 years ago.I am member of the Nehmer class action now as he was-(back to 1994)

I filed this AO claim in 2003.

Many many vets ( or their survivors)previously denied for what became a AO disability ,under the Nehmer Court Order-could have the potential (or their survivors) for more retro then they finally got.Their EED in many cases is not when they reopened because they saw their disability was put on the AO presumptive list- but actually their retro and EED could back to the first claim date when they filed if for the exact same disability.

I always bring this subject up- whenever I can-

VA doesn't even mention Nehmer in their AO awards- because they dont want us to read the entire court order and stipulation and then find out the VA might have screwed us.

VA attempted to retain MILLIONS from AO vets by failing to honor Nehmer and almost got away with it a decade ago.

NVLSP (the lawyers for Beverly Nehmer) went into the ROs and got them their proper retro.

This was a Court Order that the VA defied and still does.

They tried to pull this crap on some of our vets here- and I helped two of them 2 years ago by sending them a printout of the Nehmer retro regs to attach to their NOD and the VA then sent them the retro for the proper EED-and it didnt take too long to do that.

They hate the Nehmer decision.

Edited August 14, 2009 by Berta

[Tiki]

Thanks Berta

I applied for the PC Feb '08, had surgery Mar '08 and sent all evidence in. Evidence I was in VN, buddy letter etc., surgical report and all medical records. They responded they had my claim. Then in the summer they sent me a denial saying they didn't have any medical evidence, so my VSO sent them their signed receipt where they had acknowledged back in Mar '08 receiving the items they now say they never got. We resent the records to them also. I'm in the NY Region and I think my stuff was part of "Shreddergate".

So to answer your question, yes, my claim was denied. Then revisited. They gave me the 6 month retro last week and 40% thereafter because the C&P said I told the Doc I used 3 pads. He never even asked me. I use at least 4 and I couldn't believe he didn't broach the subject so I never said anything. Sometimes I use 1 just straightening up in the Lazyboy.

I thought I was getting 100% temporary because my PSA never went to zero and was trending up after 9 months and my Doc is planning for radiation. So I figured that's why they didn't ask about pad usage or frequency.

They're probably doing the best they can with what they've got, but it is a very sloppy bureaucracy. Any opinion on the PTSD thing ? And thanks again for all you do.