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Just Got Back From Appt With Va Psych....grrrrr

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Gridsmasher11

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I just returned from an appointment with my VA psychiatrist....She just seems to want to keep increasing my meds but doesn't really want to help with my claim.....I asked her to specifically write me a nexus letter or to put into my treatment notes that my PTSD 'is more likely than not caused by my time in the Gulf"....She says that she has already stated that it is service connected and that she wants me to be service connected for this but will not write this as I have asked....Are they instructed to not write it plainly so we can support our claims????? She said it would be a conflict of interest.????I asked her how it would be a conflict of interest, wasn't she my treating Phsychiatrist (she said yes) but she just wants to him and haww........GRRRRRRRRR...VA causes us more stress and just wants to dope us up and hope we forget...............................................Did find out some things that may help my claim......The doctor that did my PTSD C&P back in March is only an MD.....According to VA regs it should have been a Psychiatrist or Phsycologist...So I have a point there....Still gathering the stuff to keep fighting my claim.............................GRID

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OK, Folks..Been out for a few days....I did not start this as an argument about the new regs....First of all..I DO HAVE A VALID DX OF PTSD FROM A VA PSYCHIATRIST........VA HAS CONCEDED MY STRESSOR.......BUT, THE PERSON doing my rating is either not checking my treatment records or is completely ignoring them...At the end of March they denied my clain once again stating that I had PTSD but in the next sentence denying it........SO< WHATS THE PROBLEM?????I DO NOT KNOW...IF I KNEW I WULDN"T HAVE A PROBLEM .....I will continue to get all my stuff together to keep fighting this....GRID

Okay, GRID, so you want to know exactly what the problem is? Check your SOC (Statement Of the Case) letter that you received from the VA. What was the reasoning behind their denial? Did they list ALL the information that they had in their possession in the list of "evidence" that they indicated that they used to reach their decision? Did they, in fact, NOT list anything, any VA Progress Notes that they "overlooked", any pages of diagnosis, ANYTHING?

If you want to, it would be highly helpful to post your decision letter in it's entirety, so we can take a look at it and see if we can cypher their reasoning. Cover all personal information before you do so.

We be here for ya!

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Grid ,if i was you i would go ahead and submit my claim ASAP,because under the new rule,which was implemented July of 13,your claim should have been granted for PTSD but remember,your ptsd have to be corroborate with your stressor.In other words when you are talkin with your va psy at C&P,you tell he/she everything during your tour of duty in the Gulf war,if you seen people killed of people dead and burning anything that cause you to have nightmares from the gulf war, you have to tell he/she and this have to be the reason you are suffering from ptsd.This is how ptsd is connected to your inservice stressor. It is sad to have to go through this experience again and again but this is what va wants. I hope this helps

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  • HadIt.com Elder

Grid ,if i was you i would go ahead and submit my claim ASAP,because under the new rule,which was implemented July of 13,your claim should have been granted for PTSD but remember,your ptsd have to be corroborate with your stressor.In other words when you are talkin with your va psy at C&P,you tell he/she everything during your tour of duty in the Gulf war,if you seen people killed of people dead and burning anything that cause you to have nightmares from the gulf war, you have to tell he/she and this have to be the reason you are suffering from ptsd.This is how ptsd is connected to your inservice stressor. It is sad to have to go through this experience again and again but this is what va wants. I hope this helps

Mobie, they have already turned in a claim, and been denied. They need to read their SOC and see WHY they have been denied. They say that they have been diagnosed with PTSD and have a verified stressor and yet were denied. The SOC will have to come up with a reason WHY. Then, and only then, can they righteously fight this thing. Gotta know your enemy before you can beat him, right?

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Gridmashe4r's denial is EXACTLY one good reason why LarryJ and I are quite dubious about the new PTSD criteria.

But they gave a reason for the denial and without knowing the exact way they worded the reason and bases for denial we cannot determine if they could be right or overlooked some very pertinent evidence.which is probably the reason for denial- hard to say-

Also Grid, can you tell us what appellate rights they gave you when you got this?

If the VA says a vet has PTSD and then validates the stressor as it seems to be the case here- did they question that your PTSD did not raise to a ratable level???? They would still however have to grant SC at 0% and I dont think that could possibly happen much.

I am surprised they did deny you but cannot interpret why-as we don't have their reasons yet.

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Gridmashe4r's denial is EXACTLY one good reason why LarryJ and I are quite dubious about the new PTSD criteria.

But they gave a reason for the denial and without knowing the exact way they worded the reason and bases for denial we cannot determine if they could be right or overlooked some very pertinent evidence.which is probably the reason for denial- hard to say-

Also Grid, can you tell us what appellate rights they gave you when you got this?

If the VA says a vet has PTSD and then validates the stressor as it seems to be the case here- did they question that your PTSD did not raise to a ratable level???? They would still however have to grant SC at 0% and I dont think that could possibly happen much.

I am surprised they did deny you but cannot interpret why-as we don't have their reasons yet.

AHAH! Exactly, Berta, exactly ONE of my points of contention concerning this NEW and IMPROVED PTSD stuff!

You get a diagnosis of PTSD from THE VA................and, you have a validated STRESSOR...................................................and, they deny you because this PTSD does not meet somebody's (a VA "somebody" by-the-way) interpretation of a "ratable" stressor!

and, no way to fight this "somebody". NO WAY.

"me tinks dey is rottening fishes in Danemark, yes.......?"

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I would imagine this exact conversation is occurring all over the nation.

What is the proper procedure to have one's claim reviewed, re-rated, appealed etc. under these new regulations? File a new claim or wait for the VA to take the initiative to apply these new regulations to all these claims (already a 1,000,000 claim backlog):

All PTSD claims, including appeals, that are received on or after July 13, 2010.

All PTSD claims that were:

•Pending before VA on July 13, 2010

•Pending before the Board of Veterans’ Appeals (BVA) on July 13, 2010

•Pending before VA on or after July 13, 2010, because they were overturned by BVA (in cases where the claim was filed before July 13, 2010).

But in these last three situations, we must be reviewing the pending case based “on the merits.” That means that the decision must be about the “meat” of the case and not about a mere technicality.

Is having conflicting diagnoses "a mere technicality?"

To the point, the veteran I am assisting falls into the situation outlined by LarryJ and Berta with a couple of twists. First, he has a very long history of PTSD diagnoses from VA mental health providers from both VAMC and Vet Centers as well as a private provider. Secondly, he has been awarded SSDI (2005) based entirely upon his VA medical records.

However, the VA continues to deny service-connected PTSD. For years his was denied because the VA could not, or would not, verify the veteran's presence at a well publicized traumatic event (E Club fragging in VN). The veteran has testimony of a witness who placed the veteran at the event. The VA concluded that the witness was "credible" but the veteran was not. The reasons stated for this, according to the VA, the fact that the veteran has provided several stressors over the years which the VA view as "conflicting" rather the cumulative and evolving renders the veteran and his statements less than credible. Also, the VA states that since neither the witness nor the veteran was listed among the injured and the fact that the witness has never filed for service-connected PTSD, the claimed stressor in not adequate for a service-connected PTSD award. The VA is implying, incorrectly, one or the other (or both) of those elements is required by DSM-IV. The existence of these various other stressors have been revealed during PTSD treatment by VA mental health providers and are noted in the veteran's VA medical records.

JSRRC has confirmed a stressor, but not the stressor claimed (stressor letter) in the original claim for service-connected PTSD. Once the VARO received the confirmation, a new C&P (March 2010) was ordered. The C&P report states that the veteran does not suffer from PTSD but does suffer from a Personality Disorder and Depression disorder. The C&P report conflicts with VA medical records which contain numerous PTSD diagnoses right up to the C&P and continuing until as recently as two weeks ago.

The claim is very old and has traveled a very strange route. The denial was appealed to the Board in 2006 with an in-person hearing with a traveling Board member requested, but sat somewhere at the Houston RO for three years without action. So, like so many others, we cannot determine how these new regulations apply to this veteran's claim nor how to use them for his benefit (or detriment for that matter).

These questions must be answered:

Do 38 CFR "Relative Equipoise" provisions still apply?

(38 U.S.C 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990)

Do 38 CFR "Benefit of the Doubt" provisions still apply?

(38 U.S.C.A. § 1110, 5107 (West 2002); 38 C.F.R. §§ 3.102, 3.303 (2002)

Do 38 CFR "Preponderance of the Evidence" provisions still apply?

(38 U.S.C. § 5110(a); 38 C.F.R. § 3.400 (2001)

Do 38 CFR "VA required to analyze and evaluate ... all pertinent medical and lay evidence" still apply?

(38 U.S.C. § 1154(a) (2000); 38 C.F.R. § 3.303(a) (2002)

If the answer to any of these questions is "No", then veterans seeking service-connected PTSD ratings have been handed their butts!

To make it all the more confusing for us, in an IRIS response to the question of where the claim was in the appeals process, the VACO informed the veteran of the new regulations with the inference that the new regulations would help the veteran. However, shortly thereafter another SSOC was received containing yet another denial but this time stating that the veteran has a confirmed stressor but doesn't suffer from PTSD. The veteran submitted another Form 9 which simply said to refer to the 2006 Form 9 and a cover letter requesting that the RO expedite forwarding the appeal to the Board (including the in-person hearing in front of a traveling Board member at a local VA facility) based on the enormous delay that has already occurred. The veteran has received no response to date. So, we have no idea how the new regulations can or will impact the claim. Hell, we really don't even know where the claim actually (physically) is in the appeals process.

Another question has surfaced, at least for us, regarding these new regulations. If we assume, and I believe we have to at least for now, that it takes a PTSD diagnosis from a VA provider**and only a VA provider**would an IMO from a non-VA practitioner with a specialty in employment issues have any value in determining the actual rating % should be veteran succeed in getting an award of service-connected PTSD? More simply asked, "Do private mental health professionals have any relevance to the diagnosis and treatment of veterans suffering from PTSD? (I wonder what those professionals feel about these new regulations!)

While I realize I have asked more questions than I have answered, I hope this adds additional information to advance the conversation. If anyone has any answers or ideas on how to proceed, I suspect many of us would certainly like see them. If we receive more information I will post it.

Thanks.

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