Claim Nearing Decision Phase But I'm Concerned

[wpcoder]

I began a claim in August 2013, after going to the VAMC for the past 12 years from time to time for what they now call "anxiety and depression". I initially went to the VARO and they initiated a claim for "anxiety due to physical assault in basic training" and "back condition". Only on my second visit to the VARO did they provide me with Form 21-0781 for determining PTSD. The VAMC according to my medical records have never used the term "PTSD" in my file as of yet.

I have since gone to the DAV for representation, thanks in part to the great information on this website. I gave them my buddy statements to submit on my behalf since there was no documentation of the assault at the time.

I am concerned that as of today by file has been moved to the "Preparing for Decision" phase on eBenefits webpage. They estimate my claim to be complete between Jan 2014 - April 2014 - moving the window up one month from last week. That means my claim could be complete in less than six months total time.

I know I should be happy that it's not taking two years to complete, but this is almost too fast, maybe? They did the C&P for my back in October already (and have military documentation of a back condition on active duty), and I was not happy with the results when I read my records. I was unprepared and had not talked to the DAV yet, and didn't realize they rate your range of motion and not whether bending over causes you pain or not.

I have never done a C&P for PTSD or anxiety. Could they be using my medical records and buddy statements and not require a C&P? Or could that still happen?

I'm a bit naive on this whole process. I didn't even know there was such a thing as SC disability unless you got hurt in combat. Any help, thoughts, suggestions would be appreciated. Thanks.

[Navy04]

Bummer,

That we do all the hard work and research VA policies, just for them to low ball us as usual. Sorry for the misfortune, and I hope you get better %s the next round.

[meghp0405]

I knew something was up when you stated that you did not have a C/P exam. The VA is required to request a C/P exam for any and all mental health conditions. Also, the VA has eliminated using the GAF scores in determining the severity of any and all mental health conditions.

Like you said, wait until you receive your official notice and go speak with your VSO. When you go see your VSO, make sure you take all records you have from the VA to include your medical records.

It's always best to have them and not need them to need them and not have them.

Good luck!

[wpcoder]

I'm not sure if I should keep using the same thread or if the title is no longer appropriate but here goes. I got my official packet from the VA today.

10% - back

0% - anxiety disorder ("We determined that the following condition was not related to your military service, so service connection couldn't be granted.")

They say in the MST section that sexual or physical trauma can be supported by buddy statements. I gave them FOUR! Two friend, two relatives. It appears they only used one, the other three were sent after a decision was pending already.

They say their determination is because there is no record of treatment in my MSR. I didn't begin seeking treatment for anxiety until around 2000, some 13 years after the event. How plausible is it to get a doctor to write a nexus letter? I'm reading that I will need that to win an appeal. Looking forward to talking to my VSO in a couple days. Any thoughts?

Edited January 1, 2014 by wpcoder

[COOL BREEZE]

I just submited a copy of the rating section for which I should receive for my spine. It said 6 weeks of epsides=60%. So, I provided the break down and days for each epsidoe. Guess what? It comes up to over 7 months, quite a bit more than 6 weeks. I sent the font to 20, highlighted this out of the rating manual and told them based on my cervical surgery, I should be rated at either the 60% or 100%/ I did all there home work for them so if they were to low ball me, I would file a NOD-and make them see the light. Since the raters have a hard time seeing, they received 2 faxes(both received, and 2 certified letters both received with all dates =the days. And with the increased font, they won't have no excuse for unable to read or comprehend the info. Better yet, Letting them know I know the rating manual better then they do. After all, if your info =what is required to have the correct %, what is the problem other then plain stupidity!!

[meghp0405]

you will need your mental health doc to prepare you a nexus letter. He/she will have to state what you were diagnosed with, being treated for, length of time he/she has been treating you and a list of medications for this disability. The Doc will also then need to say that he/she believes (your current diagnosis) is a result of (the incident), and how and why she/he came to that decision. You need to show/prove to VA, that your disability was caused while you were on active duty.

I would take this letter, the buddy statements that were not used and submit a VA FM 21-0958 (notice of disagreement) and mail it back.

[wpcoder]

Thank you. I appreciate the advice very much. I do have a good rapport with my mental health doc, so hopefully I can get this done.

you will need your mental health doc to prepare you a nexus letter. He/she will have to state what you were diagnosed with, being treated for, length of time he/she has been treating you and a list of medications for this disability. The Doc will also then need to say that he/she believes (your current diagnosis) is a result of (the incident), and how and why she/he came to that decision. You need to show/prove to VA, that your disability was caused while you were on active duty.

I would take this letter, the buddy statements that were not used and submit a VA FM 21-0958 (notice of disagreement) and mail it back.