ptsd Reconsideration For Tbi

[ironsoldier77]

I have been seeing the TBI clinic at my va hospital for a few years now. I had previously put in a claim for mild TBI. I had multiple contact with blasts in Iraq. 2 Combat tours with 1st AD Infantry. I also have a PTSD rating of 50% and Tinnitus at 10%, total 60%. I have been unemployed since 2008 and I went through voc rehab and they found me infeasable for work,untrainable,not expected to get gainful employment. I have gone through Neuropsych testing and here is the diagnosis from that testing. I am hoping this will help me get atleast 10% so I can get TDIU. I have already put in a claim for increase on my PTSD rating,mild TBI and TDIU all at the same time. Just did this on wednesday.

CONCLUSIONS AND RECOMMENDATDIONS: Mr. Anderson is a 32 year old,White,married and unemployed when the last testing session was completed. His work ihistory does not reflect stable emplyment. He was referred for a cognitive evaluation by his primary care provider after complaining of difficulty in concentrating and meory problems. He has an unremarkable academic history with a high school graduation and one semester of college. HIs family of origin was stable:however his father died just before he left for Iraq. H has a stable relationship history in his only marriage of eight years. He has three years of credible service in the the army with two combat tours to Iraq. He reports being stunned from multiple blast in juries while serving in Iraq. He has no history of substance abuse , or legal problems. His social life is limited to family due to anxiety associated with being in crowds and other symptoms of PTSD. He generally functions idependently and attends to his activities of daily living.His premorbid level of verbal intellectual functioning was estimated to be high average. Current intellectual functioning was in the average reage. All IQ scores were in the average range except for working memory which was low average. He has mild impairment in concentration and focusing on information in the auditory channel. Mild impairment in concentrating and focusing could contribute to the mild loss of intellectual functioning reflected in the drop from high average to average intelligence. Memory functioning was avearage to low average. Auditory memory, visual working memory and immediate memory were lower than expected for his intellectual functioning. Visual memory was intact despite mild difficulty in focusing and concentrating on visual channel information. He has had significant losses of memory abilities. His observed behavior, history and the test data are consistent with the following diagnoses:

Axis I-Mild Cognitive Impairment likely associated with Blast Injuries

Posttraumatic Stress Disorder

Depression (ICD-9-CM 311./300.4)

Insomnia (ICD-9-CM 780.52)

Tobacco use disorder

Axis II-NONE

Axis III-Brain diseases due to trauma (ICD-9-CM 3)

Acute pharyngitis

Low back pain

Knee: arthralgia

Tobacco use disorder

Axis IV-Exposure to combat and loss of job

Axis V- GAF=55, mild to moderate impairment

Medical problems that could contribute to cognitive impairment include brain disease and pain. PTSD, depression and insomnia could also contribute to impaired concentration. Hearing impairment could contribute to auditory memory problems and a hearing examination may be warranted. HIs past history of having tubes in his ears as a child could have contributed to a failure to develop auditory memory abilities. Medications that could contribute to cognitive impairment include clonazepam, but this is usually seen in much older patients. Mr. Anderson may benefit from medications that target concentration like those used in the treatment to attention deficit disorder,and an evaluation for a trial of one of these medications is recommended. Unfortunately the prognosis for PTSD with mild traumatic brain injury is worse than the prognosis for PTSD without brain injury. Most of the treatments for PTSD involve learning new strategies for managing the symptoms of PTSD, and when learning is impaired, progress in treatment may be slowed. Continued treatment for depression, insomnia and PTSD is recommended. He is also being seen in the speech pathology for cognitive rehabilitation and this should be continued until maximum benefit is achieved. With the recent loss of his employment, a vocational rehabilitation referral may be warranted, depending upon his progress in the PTSD outpatient treatment program.

So, thats the report from the doctor that did the psych testing. When I read this it almost sounds like a "slam dunk" and that I might get awarded a SC for mild TBI. I really hope it does, because it would make me eligable for TDIU, which is what I really need. I was also wondering if its possible that the VA could go ahead and award 100% P & T instead of just TDIU?

I am on full SSD benefits as well and that along with my VA benefits at 60% is all i have to live by. We barely have enough to keep our house. I am almost at the point to where my life just seems meaningless and I really hope I get the TDIU, mild TBI and increase for my PTSD. Im having a hard time gettng an increase for my PTSD. It seems that i have to be some deranged lunatic, murder someone or get locked up. to be even considered for an increase. I dont know what to say when I go to the C&P exams for PTSD increases.

[Berta]

Ok I just got the packet in the mail today from the VA with the VCAA response letter. It says they are working on my claim for PTSD and IU. They are not reconsidering my TBI decision, because they say I have no new evidence!!! WTF??? I sat with my VSO and gave him the TBI doctors notes which shows a clear diagnosis of mild TBI(mild cognitive impairment likely associated with blast inuries). I know it was in the packet that my VSO typed up, I saw him staple it all together. And in our packet we asked for reconsideration because I now have a clear diagnosis, and the doctors notes are in this paperwork for them to look at. This is my 3rd time apply for TBI and also my 3rd time for TDIU. Seems to me that someone over there is not doing their damn job!! How could they not look at my new evidence???"

They did it to me for almost 7 years on my last claim and for 3 years on another past claim.I know exactly how you feel.

"I have copies of the packet my VSO sent to them and from me looking at it, it would be really hard to miss that evidence. Which leads me to believe that the VA is just trying to screw me AGAIN! UGGGGGHHHHH!! Im so pissed off right now and frustrated because now I have to try and figure out what im supposed to do to make them look at all my evidence! This is not right and someone should be fired for not doing their job. I know they probably just do this stuff to make people give up, but Im going nowhere until I get my claim approved like it should have been almost 2 years ago."

"I just got the packet in the mail today from the VA with the VCAA response letter. It says they are working on my claim for PTSD and IU." One problem I had was a deficient VCAA letter and my reps tried to tell me I was wrong.They would not support my request for a proper VCAA letter. The BVA found out I was right-

I suggest you definitely respond to this VCAA letter with copies of ALL of the critical evidence you have and with a cover letter describing it.

I know it is miserable to copy all of that stuff again but it looks to me that they did not receive what the rep sent to them.Make sure that you get a proof of mailing.

The VCAA response form ( which I never received for my last claim- so they wrote to me and said I had failed to respond to what they didn't send- what a scam )

does trigger,in my opinion, more attention to the claim.

When you send in the evidence, send it Attention to: and use the initials that are in upper right hand corner (hopefully) of the VCAA letter.

I am sitting here having flashbacks of years of this same bull crap from the Buffalo VARO. I complained to the OIG that the feds must be hiring illiterates at these ROs and then found that some odd stuff went down between my rep and the DRO.

The first time my evidence was ever acknowledged was by the BVA,many years after I filed the claim.

I think their receipt of your VCAA response form will get this moving better for you.

You can send your rep a copy of the response form for the record but I feel you should definitely mail this yourself and within 3 weeks it should be appearing on their computers to verify at 800# that they got it.

Definitely appeal their reconsideration denial- you might be better off asking them to CUE themselves as to their disregard of the New evidence.

[ironsoldier77]

Thank you Berta! This is the kind of information I was hoping to get from the pros here on Hadit. I am going to do exactly as you say. I know for a fact this is NEW evidence. And if the VA thinks im just gonna give up out of frustration, well, they got another thing coming! They wanna play games? Thats ok, Im the one who will win in the end, and they will have to pay me alot of retro pay for sitting on this for so long. I feel much better now after reading your advice!! Time to start making copies!!

Ok I just got the packet in the mail today from the VA with the VCAA response letter. It says they are working on my claim for PTSD and IU. They are not reconsidering my TBI decision, because they say I have no new evidence!!! WTF??? I sat with my VSO and gave him the TBI doctors notes which shows a clear diagnosis of mild TBI(mild cognitive impairment likely associated with blast inuries). I know it was in the packet that my VSO typed up, I saw him staple it all together. And in our packet we asked for reconsideration because I now have a clear diagnosis, and the doctors notes are in this paperwork for them to look at. This is my 3rd time apply for TBI and also my 3rd time for TDIU. Seems to me that someone over there is not doing their damn job!! How could they not look at my new evidence???"

They did it to me for almost 7 years on my last claim and for 3 years on another past claim.I know exactly how you feel.

"I have copies of the packet my VSO sent to them and from me looking at it, it would be really hard to miss that evidence. Which leads me to believe that the VA is just trying to screw me AGAIN! UGGGGGHHHHH!! Im so pissed off right now and frustrated because now I have to try and figure out what im supposed to do to make them look at all my evidence! This is not right and someone should be fired for not doing their job. I know they probably just do this stuff to make people give up, but Im going nowhere until I get my claim approved like it should have been almost 2 years ago."

"I just got the packet in the mail today from the VA with the VCAA response letter. It says they are working on my claim for PTSD and IU." One problem I had was a deficient VCAA letter and my reps tried to tell me I was wrong.They would not support my request for a proper VCAA letter. The BVA found out I was right-

I suggest you definitely respond to this VCAA letter with copies of ALL of the critical evidence you have and with a cover letter describing it.

I know it is miserable to copy all of that stuff again but it looks to me that they did not receive what the rep sent to them.Make sure that you get a proof of mailing.

The VCAA response form ( which I never received for my last claim- so they wrote to me and said I had failed to respond to what they didn't send- what a scam )

does trigger,in my opinion, more attention to the claim.

When you send in the evidence, send it Attention to: and use the initials that are in upper right hand corner (hopefully) of the VCAA letter.

I am sitting here having flashbacks of years of this same bull crap from the Buffalo VARO. I complained to the OIG that the feds must be hiring illiterates at these ROs and then found that some odd stuff went down between my rep and the DRO.

The first time my evidence was ever acknowledged was by the BVA,many years after I filed the claim.

I think their receipt of your VCAA response form will get this moving better for you.

You can send your rep a copy of the response form for the record but I feel you should definitely mail this yourself and within 3 weeks it should be appearing on their computers to verify at 800# that they got it.

Definitely appeal their reconsideration denial- you might be better off asking them to CUE themselves as to their disregard of the New evidence.

[ironsoldier77]

In my VCAA response I am including the ROI form for my SSD. What address do I put down for them to check my records. My local office or the main office???

[ironsoldier77]

Ok I saw my VSO today and this is what we did.

[ironsoldier77]

Anyone have an opinion on this?? Would really appreciate it! Thanks!

[carlie]

1) I wonder why both pages were not done on one page, this usually makes for more confusion.

2) The examiner opined your memory impairment was not due to TBI.

The New/Additional medical evidence must fully rebutt this opinion and be supported

with full medical rationale.

If not, it will most likely be viewed as a difference of opinions and the decision maker has the

authority to choose which opinion they will give more weight to.

This would be unless the New/Additional medical evidence comes from a doc that has a higher pedigree

and/or supports their opinion much more fully and detailed.

I would say if it were me my goal would be to at least get the medical evidence in relative equipoise

thereby pushing the envelope for the BOD to be applied.

I must be more tired than I thought.

I've been reading over your past posts and started wondering if you are filing a reconsideration

or NOD - by reading the two different 21-4138's it looks like you are having both going at the same time

and is this the second time you have requested reconsideration on the denial of TBI.

I sure hope the VARO is understanding all of this because it's beginning to look like

a cluster XXXX to me.

But - I did say I am tired.