Jump to content
  • Searches Community Forums, Blog and more

  • Advertisemnt

  • 0
TracyK

Dro Appeal For Tdiu Denied Then Mh Diagnosis Changed

Question

Hi All,

I'm a newbie that was sent here by my brother-in-law. He received a tremendous amount of help from Berta on his TDIU claim and was eventually successul - so on his behalf I thank all of you for helping him and hope you can now help me.

I am currently 60% SC. October 2008 applied for TDIU. Initially upfront denied because I did not meet schedular requirements of either 70% SC or one SC rating of 40% or higher. (I am 30%, 30% and 10%) I appealed to DRO, she ordered new C&P's. I have been receiving treatment through the VA for the last 2 years for my 30% SC Depression rating. Having not had a C&P for the last 20+ years, the DRO thought it likely that a new C&P would show that the condition had worsened. She wanted to address meeting the schedular requirements within the same appeal for TDIU.

What I found out at the C&P was that my psychiatrist had neglected to properly annotate my file with the severity of my condition. I pleaded with the reviewer to hear me and to accurately document my condition. He listened and I thought it went in my favor.

Last Friday I got the denial and was shocked! No increase and up front denial of TDIU for not meeting schedular requirements. I immediately appealed to BVA.

Today I met with a new psychiatrist and he has determined that I have been misdiagnosed all this time and that I actually have bipolar disorder.

What is the best thing for me to do now? I appreciate any help you can give me!

TracyK

Share this post


Link to post
Share on other sites

Recommended Posts

"Today I met with a new psychiatrist and he has determined that I have been misdiagnosed all this time and that I actually have bipolar disorder."

Did he link your bi polar directly to your service or to your service connected depression?

Did he change your medication?

Would he be willing to provide a medical statement that reflects the new diagnosis, that it is directly due to your service or to the depression and that it should be re evaluated?

You could ask the DRO to Reconsider their decision with any new and relevant info from this new doctor.

Although you filled out the I-9 BVA appeal form- the claim wont be getting to the BVA to fast and yo have time- with sgnificant evidence to request a reconsideration of the DRO's decision.

Do you have a copy of the actual C & P results to show the new psychiatrist?

Would the new bi polar diagnosis -in his opinion- warrant a different rating?

Is this a VA doctor or a private new doctor?

The ratings for any mental health issue are determined by medical evidence.However other evidence as well can come into play. Any performance appraisals of past on the job behaviors can often help a TDIU claim.

One of my best friends is 100% P & T SC for bi polar.It was his inservice personnel records (not his SMRs)that helped him gain this award.His VA shrink agreed.

Share this post


Link to post
Share on other sites

Ad


Hi Berta - you are actually the lady who most helped my brother-in law!:biggrin:

Please see my answers below

"Today I met with a new psychiatrist and he has determined that I have been misdiagnosed all this time and that I actually have bipolar disorder."

Did he link your bi polar directly to your service or to your service connected depression?

He said that the the major depression I am SC for is actually bipolar disorder and notated my file of the correct diagnosis for the service-connected mental health condition.

Did he change your medication? Yes. I was on Prozac and still very, very depressed so he put me back on zoloft and added lithium.

Would he be willing to provide a medical statement that reflects the new diagnosis, that it is directly due to your service or to the depression and that it should be re evaluated? I believe that he would. He did a whole lot of notating in my file while I was with him.

You could ask the DRO to Reconsider their decision with any new and relevant info from this new doctor.

How should I go about doing that? By letter?

Although you filled out the I-9 BVA appeal form- the claim wont be getting to the BVA to fast and yo have time- with sgnificant evidence to request a reconsideration of the DRO's decision.

Do you have a copy of the actual C & P results to show the new psychiatrist? I have requested my c-file

Would the new bi polar diagnosis -in his opinion- warrant a different rating? Definitely have to ask

Is this a VA doctor or a private new doctor? New VA shrink, the old one was a nightmare.

The ratings for any mental health issue are determined by medical evidence.However other evidence as well can come into play. Any performance appraisals of past on the job behaviors can often help a TDIU claim.

One of my best friends is 100% P & T SC for bi polar.It was his inservice personnel records (not his SMRs)that helped him gain this award.His VA shrink agreed.

If push comes to shove there is something in my service records I can use. One month I was Airman of the Month...the very next month I got an Article 15 for insubordination when I had never been in trouble before!

Share this post


Link to post
Share on other sites

Can you answer this for me? I was diagnosed with obstructive sleep apnea by a private doctor 4 years ago. I cannot tolerate the mask so I have been suffering. Until my medical C &P the VA did not know about this. The Dr that did my C&P was a neurologist, saw my palate and said he wouldn't be surprised if I had it - I told him that I did...he noted it in my C & P.

I told my Primary Dr about it at checkup and asked her to send a consult to the sleep lab so I could now be seen thru VA...she did, I'm on wait list.

Now, I have recently discovered that the SC mental health issue and the treatment I have been receiving for it are "more likely than not" having an effect on the severity of my sleep apnea. I think it is likely that it could be a secondary issue to the mental health rating and therefore be service-connected and rated. I can go get my records from my private doc and I'll be he will be willing to write exactly that statement for me.

How can I get this considered in my current claim? Can I get it in as new evidence, along with the new diagnosis as a way to try to get the DRO to reconsider?

I get a headache just thinking about this stuff!

Share this post


Link to post
Share on other sites

Even though it may take a while to get your C File you can go to the VA and review it with a VA Councilor. Some of the RO require an appointment but so few vets do it at Waco that you can usually do it just walking in. I would call 800 827 1000 and ask for an appointment.

I did this a couple of times with other Veterans and they were able to get copies of documents they needed and a dialogue with the Councilor helped speed up their claim.

Share this post


Link to post
Share on other sites

"I am currently 60% SC. October 2008 applied for TDIU. Initially upfront denied because I did not meet schedular requirements of either 70% SC or one SC rating of 40% or higher. (I am 30%, 30% and 10%) I appealed to DRO, she ordered new C&P's.

I have been receiving treatment through the VA for the last 2 years for my 30% SC Depression rating. Having not had a C&P for the last 20+ years, the DRO thought it likely that a new C&P would show that the condition had worsened. She wanted to address meeting the schedular requirements within the same appeal for TDIU.

What I found out at the C&P was that my psychiatrist had neglected to properly annotate my file with the severity of my condition."

Questions:

When were you granted your 60 % SC ?

If the 3 disabilities were granted on one Rating Decision, what exactly did that

Rating Decision state in the Evidence and Reasons and Bases Section ?

You are 30 % SC for depression.

You are 30 % SC for ___________.

You are 10 % SC for ___________.

What treatment had you been receiving through the VA for the last 2 years and during this time did you receive any

one on one therapy or group therapy, or mental health services from a Vet Center, or private treatment ?

The reason I ask this is because generally speaking, absent some very special circumstance's, Psychiatrist's at the VAMC's

do not provide therapy or treatment other than the basic quarterly 15 minute appointment for medication management, or

an initial mental health evaluation in response to a referral from another VAMC doctor.

"I pleaded with the reviewer to hear me and to accurately document my condition. He listened and I thought it went in my favor.

Last Friday I got the denial and was shocked! No increase and up front denial of TDIU for not meeting schedular requirements."

Question:

What exactly is stated in the Evidence and Reasons and Bases Sections of the Rating Decision ?

"I immediately appealed to BVA."

Question:

So you have completely filled out and submitted a Form 9 - Substantive Appeal to the BVA.

What did you state on your Form 9 ?

Did you mail it in RRR or submit it in person and get a date stamped copy ?

"Today I met with a new psychiatrist and he has determined that I have been misdiagnosed all this time and that I actually have bipolar disorder."

Information and a Question:

The VBA only compensates for one mental health disability. All of the different mental health disabilities fall under the same criteria in regards

to what percentage is granted.

Very often a person will have more than one mental health disorder an example could be PTSD and Panic Disorder.

When this is the case the two mental health disorders are referred to as comorbid.

Whether a vet has comorbid service connected MH disorders or a single MH disorder, the VA is to provide the highest rating allowed by the

medical evidence of record which is measured by Occupational and Social impairments.

What type of testing did your "new psychiatrist" do ?

A change in your MH diagnosis may change the medications you are RX'd but it will not change the percentage you are compensated at.

Someone else has already posted the different percentage criteria's for you.

Have you requested a copy of all of your VAMC records ?

"What is the best thing for me to do now? "

Answer:

If you have just filed your appeal to the BVA you should more likely than not have plenty of time to get copies of your treatment / therapy records.

I would be sure to request any and all MH records, C&P exams, and the progress notes from your new "psychiatrist".

carlie

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Ads


  • Advertisemnt


  • Latest News
  • Our picks

    • Survivors- a Must read
      If you are new to hadit and have DIC questions it would help us tremendously if you can answer the following questions right away in your first post.

      What was the Primary Cause of Death (# 1) as listed on your spouse’s death certificate?

      What,if anything, was listed as a contributing cause under # 2?

      Was an autopsy done and if so do you have a complete copy of it?

       It can be obtained through the Medical Examiner’s office in your locale.

      What was the deceased veteran service connected for in his/her lifetime?

      Did they have a claim pending at death and if so what for?

      If they died from anything on the Agent Orange Presumptive list ( available here under a search) when did they serve and where? If outside of Vietnam, what was their MOS and also if they served onboard a ship in the South Pacific what ship were they on and when? Also did they have any major  physical  contact with C 123s during the Vietnam War?

      And how soon after their death was the DIC form filed…if filed within one year of death, the date of death will be the EED for DIC and also satisfy the accrued regulation criteria.
        • Like
      • 17 replies
    • If you are a Veteran, represented by MOPH, you need to know that MOPH is closing down its offices.  This can have a drastic effect on your claim, and it wont be good for you.  You likely need to get a new representative.  

      This station confirms MOPH is closing its doors:

      http://www.kwtx.com/content/news/Waco--Purple-Heart-veterans-service-center-to-close-its-doors-480422933.html

       
      • 0 replies
    • Retroactive Back Pay.
      Retroactive Back Pay - #1Viewed Post Week of March 19. 2018

      My claim is scheduled to close tomorrow for my backpay.
      Does anyone know if it does close how long till the backpay hits the bank?
      Also does information only get updated on our claims whenever the site is down?
      • 44 replies
    • Examining your service medical records...
      * First thing I do after receiving a service medical record is number each page when I get to the end I go back and add 1 of 100 and so on.

      * Second I then make a copy of my service medical records on a different color paper, yellow or buff something easy to read, but it will distinguish it from the original.

      * I then put my original away and work off the copy.

      * Now if you know the specific date it's fairly easy to find. 

      * If on the other hand you don't know specifically or you had symptoms leading up to it. Well this may take some detective work and so Watson the game is afoot.

      * Let's say it's Irritable Syndrome 

      * I would start page by page from page 1, if the first thing I run across an entry that supports my claim for IBS, I number it #1, I Bracket it in Red, and then on a separate piece of paper I start to compile my medical evidence log. So I would write Page 10 #1 and a brief summary of the evidence, do this has you go through all the your medical records and when you are finished you will have an index and easy way to find your evidence. 

      Study your diagnosis symptoms look them up. Check common medications for your IBS and look for the symptoms noted in your evidence that seem to point to IBS, if your doctor prescribes meds for IBS, but doesn't call it that make those a reference also.
      • 9 replies
    • How to get your questions answered on the forum
      Do not post your question in someone else's thread. If you are reading a topic that sounds similar to your question, start a new topic and post your question. When you add your question to a topic someone else started both your questions get lost in the thread. So best to start your own thread so you can follow your question and the other member can follow theirs.

      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.



      Leading to:

      Post clear questions and then give background info on them.



      Examples:

      A. I was previously denied for apnea – Should I refile a claim?



      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?




      B. I may have PTSD- how can I be sure?


      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?





      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

      Note:

      Your firsts posts on the board may be delayed before they show up, as they are reviewed, this process does not take long and the review requirement will be removed usually by the 6th post, though we reserve the right to keep anyone on moderator preview.

      This process allows us to remove spam and other junk posts before they hit the board. We want to keep the focus on VA Claims and this helps us do that.
      • 2 replies
  • latest-posts-activity.pngstart-new-topic.pngsearch.png

  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • Advertisemnt

  • 14 Questions about VA Disability Compensation Benefits Claims

    questions-001@3x.png

    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
    Continue Reading
     
  • Advertisemnt

  • Ads

  • Can a 100 percent Disabled Veteran Work and Earn an Income?

    employment 2.jpeg

    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

×

Important Information

{terms] and Guidelines