Jump to content


  • hate-ads-subscribe-now.jpg

  • Ad
  • Ad
  • 14 Questions about VA Disability Compensation Benefits Claims


    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
  • 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

  • Ad

Recommended Posts


Department of Veterans Affairs VHA DIRECTIVE 2012-025
Veterans Health Administration
Washington, DC 20420 September 17, 2012
1. PURPOSE: This Veterans Health Administration (VHA) Directive defines the policy for
responding to requests from Veterans Benefits Administration (VBA) for compensation and
pension (C&P) disability evaluations and appropriate use of the Acceptable Clinical Evidence
(ACE) process. AUTHORITY: Title 38 United States Code 5103A(d); and Title 38 Code of
Federal Regulations 3.159©(4).
2. BACKGROUND: ACE may be used whereby clinicians may consider the medical evidence
currently in existence and a Veteran’s claims file, supplemented by a telephone interview if
necessary, and use that existing evidence to prepare a Disability Benefits Questionnaire (DBQ)
instead of requiring some Veterans to be examined in-person.
a. VHA provides Veterans with disability evaluations allowing them to obtain the benefits
for which they are eligible. This process is a major VHA responsibility and of great importance
to Veterans and stakeholders.
b. The ACE process does not replace existing VHA policy providing guidance on the C&P
disability evaluation process to obtain medical information to assist in the adjudication of claims.
This Directive provides the VHA clinician with information about the ACE process.
c. VBA determines whether additional medical evidence is required to decide a claim, unless
the Board of Veterans’ Appeals (BVA), United States (U.S.) Court of Appeals for Veterans
Claims, or U.S. Court of Appeals for the Federal Circuit has remanded a claim and requires an
in-person evaluation or opinion.
d. Unless VBA personnel have specifically required that an examination be conducted, once
VBA has requested an evaluation or opinion and provided all available medical information to
VHA, a VHA C&P disability clinician reviews the request and, if use of the ACE process is
determined by the clinician to be appropriate, completes the DBQ using the ACE process, or
refers the request to the appropriate VHA C&P disability clinician to complete the DBQ using
the ACE process. The ACE process may include a telephone interview to supplement the
available records. If additional information is required, the ACE process is not used, and the
Veteran is scheduled for an in-person medical examination or telehealth examination. When the
ACE process is used, the clinician must ensure the appropriate entry is made on the DBQ to report
the use of the ACE process, and must explain, in the DBQ Remarks section, the source of the
clinical evidence relied on to complete the DBQ.
e. There will be some claims for which an ACE review cannot be done; those claims are
clearly identified by VBA in the C&P disability evaluation request. For example, the ACE
process cannot be used if a BVA Remand orders that an examination be conducted.
September 17, 2012
f. Definitions
(1) Examination. An examination is a medical professional’s personal observation and
evaluation of a claimant. It can be conducted in person or by means of telehealth.
(2) Evaluation. An evaluation is an assessment of the medical evidence, which may involve
conducting an examination, providing an opinion, or both.
(3) Opinion. An opinion refers to a medical professional’s statement of findings and views,
which may be based on review of the claimant’s medical records or personal examination of the
claimant, or both.
3. POLICY: It is VHA policy that effective October 15, 2012, VHA C&P disability clinicians
must use the ACE process to respond to VBA requests for medical evaluations when the VHA
C&P disability clinician determines it is appropriate to do so, based on the medical evidence in
the medical record, supplemented by a telephone interview if necessary.
a. Under Secretary for Health. The Under Secretary for Health is responsible for the
quality and timeliness of VHA C&P disability evaluation process, and ensuring that resources
are allocated in support of the process.
b. Office of Disability and Medical Assessment. The Office of Disability and Medical
Assessment is responsible for:
(1) Ensuring implementation of, and compliance with, this Directive.
(2) Establishing monitors as part of DMA’s audit review by December 30, 2012.
(3) Providing guidance through regular conference calls, web-based training, etc., to VHA
C&P disability clinicians, in cooperation with Patient Care Services and VBA.
(4) Ensuring that medically accurate training on the ACE process is provided to the
appropriate VHA clinicians.
(5) Making recommendations for process changes and improvements.
(6) Reviewing selected ACE evaluations to ensure medically-appropriate content.
c. Veterans Integrated Service Network (VISN) Director. Each VISN Director is
responsible for:
(1) Ensuring that requirements for training, credentialing, and privileging are completed.
(2) Ensuring that a Veteran-centric approach to the ACE process is established. VHA DIRECTIVE 2012-025
September 17, 2012
(3) Ensuring that close collaboration with VBA regional offices is established and
(4) Monitoring the usage of the ACE process within the VISN.
d. Facility Director. Each Facility Director is responsible for:
(1) Ensuring that ACE is conducted, when appropriate, in response to a C&P disability
evaluation request received by the facility.
(2) Ensuring ACE reviews are conducted only for evaluation requests for Veterans within
the VHA facility’s VISN. There are limited circumstances when VHA clinicians conduct
reviews of medical evidence from VHA facilities outside their VISN. For example, a Pension
Management Center, a Resource Center, or a Restricted Access Claims Center could request
local VHA clinicians to review records from a different VISN. With that exception, however,
VHA clinicians using the ACE process only review records consistent with the regional
responsibilities of the clinician’s facility.
(3) Ensuring, upon receipt of a request for a C&P disability evaluation or opinion, the VHA
C&P disability evaluation clinician decides if ACE is appropriate based on a review of the
medical record(s) and claims file, supplemented by a telephone interview if necessary. NOTE:
A request may be for multiple disability evaluations for one Veteran.
(4) Ensuring conditions that may be successfully addressed in an ACE review include, but
are not limited to:
(a) Prostate and other genitourinary conditions, which have already been assessed.
(b) Some oncology cases, whether the cancer is active and/or primary site identification, if
© Ischemic Heart Disease, for which a functional assessment may be done by a telephone
(d) Tinnitus can sometimes be assessed in a telephone interview when a current audiometric
examination is already documented.
(e) Hypertension can be addressed by the ACE method if the record contains current blood
pressure readings.
(f) Pulmonary conditions.
(5) Ensuring medical opinions are provided using the ACE process when the existing
records provide adequate information. Opinions are provided for:
(a) Clarifying a previous medical evaluation, VHA DIRECTIVE 2012-025
September 17, 2012
(b) Clarifying a previous medical opinion, or
© Providing a new opinion.
(6) Ensuring the ACE process is not used for mental health disability examinations.
(7) Ensuring the DBQ indicates when the ACE process is used, and identifies the materials
reviewed to complete the DBQ or render the opinion. The DBQ contains a box that must be
checked if the DBQ was completed using the ACE process.
(8) Ensuring if the ACE process involves obtaining information from a Veteran by telephone
interview, current VHA policy must be followed, including the procedures VHA staff need to
use to authenticate the identity of individuals requesting medical care, treatment, or services at
VHA. NOTE: These identification procedures ensure that the Veteran is the person being
(9) Ensuring that if the ACE process involves telehealth, the evaluation is conducted in
accordance with established VHA telehealth policy including policies and procedures located on
the VA Telehealth Services Web site at: http://vaww.telehealth.va.gov/index.asp. NOTE: This
is an internal Web site and is not available to the public.
(10) Ensuring that adequate methods of workload documentation are used to support time
allocations and staffing levels to complete evaluations in a timely and sufficient manner, and in a
way that can be aggregated in Decision Support System.
5. REFERENCES: VHA Handbook 1601E.01.
6. FOLLOW-UP RESPONSIBILITY: The Office of Disability and Medical Assessment
(10NC8) is responsible for the contents of this VHA Directive. Questions may be referred to the
Director, Clinical Programs and Administrative Operations at 202-461-6699.
7. RESCISSION: None. This VHA Directive expires September 30, 2015.
Robert A. Petzel, M.D.
Under Secretary for Health
DISTRIBUTION: E-mailed to the VHA Publications Distribution List 9/18/2012

Share this post

Link to post
Share on other sites



As usual people on here like you, Berta and Megh have listed on here so much useful information. You guys are very dedicated to helping a lot of us Vets that are just tired of being tired. Thanks again and hope you have a safe weekend.

Share this post

Link to post
Share on other sites
Sign in to follow this  

  • Similar Content

    • By Andyman73
      Recently I was DX and granted SCD for PTSD due to personal trauma (MST). I have also noticed a dramatic reduction in performance capabilities as well. I have not mentioned this to any of my doctors, VA or private. It's been hard enough to admit to the MST, without having to add the ED to it. But I've reached a point where I can no longer ignore it.  I'm only 44 years old and have far too much life left to live to continue ignoring the ED. I'd like to hear any suggestions or guidance as to the best way to file a claim for this as secondary to my SCD PTSD. Any and all suggestions from all parties are welcome. Also, should I start with making an appointment with my PCP?  Thank you to all who read and respond to this delicate and humbling matter.
      Semper Fi
    • By tazntaylr
      I have been working with a VSO to file my claim. I am currently in the process of gathering information. Only thing, file for MST with PTSD or file PTSD. VSO was hung up on the sexual part of MST.
      Was in service 1991-2000. In 1995 was involved with a female soldier, who also was involved with another male (married) soldier. After an exercise and the last night sleeping together she asked me to kill his wife. After the second time I went to CID and wore a wire twice. While the Article 32 hearing was going on she was let out of pre-trial and started harassing me, being around me. I was moved from my company to another, and ultimately to the brigade HQ (rear detachment). Brigade HQ was deployed then. Both the female soldier and male soldier were other than honorable discharged, but I was exiled for a year. Not the same after. As I was getting out in 1999 I learned that she had asked other people in the unit to kill me. I was seen at a Vet center into 2000.
      Same time as the Article 32, my chain of command was trying to discipline me for an Article 15/court martial. The incident was with the female soldier (before she had asked me) and was on a trumped up charge. Even had the 1st sergeant threatened me in his office about "if he could not get me on that charge he would find another". After my time in Brigade HQ I returned to almost a new unit, only 5% knew me. All I wanted was out, but he harassed me every day to change my mind and go to the promotion board. Would not even let anyone drive me to airport to PCS.
      It took my wife to point out that when I get harassed or witness it at work that I am affected by it. I am currently being seen for it by the Vet center I was seen at before. The vet center had listed me as PTSD and marked as military trauma. 
      Also, I don't have anything from that time as I was not in a good place and as a 26 year old did not want the reminders in my barracks room. So if anyone knows how to get the CID or JAG records I am all ears.
    • By VietnamVetSis
      Has anyone had any luck with claiming Sleep Apnea as secondary to Hypertension and/or Arteriosclerotic Heart Disease ?  My husband has service connection for both hypertension and heart disease and now a current diagnosis and medical equipment for sleep apnea.  I've read where VA has approved hypertension secondary to sleep apnea and heart disease secondary to sleep apnea, but not the other way around. If anyone has an archived VA citation in this regard, or personal experience, would greatly appreciate hearing about it.    Thanks all.
    • By Broken Cat
      I am in the process of putting together a claim package for mental health issues related to MST.  Try as I might, I cannot find a VSO with experience in my situation.  It's taken me years to accept that I need help and that I need to address this once and for all, so when I say that I cannot handle doing this twice (submitting a sub par claim and then doing appeals) I really mean it. From day to day, I vacillate between thinking my problems are actually other people's inability to cope OR feeling like there is no point to me and that I'm a burden.If it weren't for the whole not being able to pay bills and risking alienating my kids for all eternity, I'd be perfectly content letting the world turn while I hang out at home and being maladjusted and mean.
      In my perfect world, there would be a check list of things to submit for a fully developed claim. On this checklist, there would be a list of key phrases or high points that would help sway the decision makers into awarding adequate compensation. I haven't been able to find anyone that has had success doing this with a case like mine.  I have police reports from the MST.  I have trauma counseling records and AD medical records that clearly state a d/x for PTSD related to rape on X date. My counseling sessions identified dissociation behaviors, PTSD, and anxiety. One doctor even noted that I was combative and stated that I wished harm on my attackers. 
      Obviously, the Navy handled this clear cut case of rape, with evidence and my complete cooperation, like they do any scandal.  They buried it and came after me.  That might be a secondary stressor, but I've been warned that claiming a secondary stressor could hose up everything and to keep my mouth shut?  kind of amazing that the advice that is meant to help, sounds a lot like the advice that sent me careening out of control all those years ago.
      Anyhow, I survived, got married, got out, and went in and out of counseling.  Over the years, I've been diagnosed with PTSD, Chronic Depression, Chronic Adjustment Disorder, Agoraphobia, Generalized anxiety Disorder, and Dissociation Disorder.  I don't trust military medicine or the government, so most of my counseling was done through non-profit organizations and women's shelters. They're so secretive, that I felt it'd be safe to tell them what I went through and my statements wouldn't end up in the Navy's summary of Mishaps... again. So, I don't really have records of those, except for prescriptions that were reported to Tricare.   I do have my civilian medical records. It has page after page of doctors complaining that I broke down, was combative, emotional etc, etc.  I do have a few sessions with shrinks at MTFs in the last couple years. They were not keen on actual diagnostics, they just gave me the pills I asked for.
      I'm shopping shrinks to assess me and give diagnosis. I'm not sure I need a nexus letter, but I'm thinking it wouldn't hurt.  I have a letter from my ex boss describing how my work performance plummeted over the years and how he made accommodations to keep me on. I also have a letter from me, describing my bad days and my rituals to get through them. My husband and his best friend were witnesses to the fallout of my rape, in terms of the military's response to me.  They can verify in statements that I did report it and go into counseling. They can also verify that I'm socially isolated and very codepenedent on them to meet new people or get involved in activities.  I don't have a single friend that they didn't make for me, first.  I do not know how to people. I don't have friends from work. I don't have "my own" friends from church. I don't even have people who like me well enough, and include me in things, without my husband and his best friend acting as intermediaries.  
      oh, I also have the most recent sentencing transcripts for the ringleader of my attackers.  The judge stated that he felt this dude was unrepentant and a monster. He cited his past sex crimes, "both in the record and that didn't make it to trial" and his history of convincing others to help him conceal his crimes.  If that's not a shout out from the bench, I don't know what is.

      Anyhow, I guess my question is, has anyone here done a fully developed MST claim with multiple bullet points for anxiety, phobia, ptsd, and depression, and get 100% or at least, a high enough rating to qualify for unemployability?  Without having to go through appeals and lawyers?  Was a police report enough, even if the military dropped it?  Should I give the C&P my evidence, letters, and my personal statement too? I'm sure I have 1000 more questions,  but I'm mostly looking for someone who has done what I'm trying to do.
    • By Shake-n-Bake
      I am still awaiting the notification letter with full details but, according to eBenefits, they have denied my claim for hypertension secondary to PTSD. The basis of my claim was not so much that the PTSD caused the hypertension (although I suspect it may have), but that my PTSD aggravates the hypertension. It looks like the decision was based on the C&P examiners opinion that my hypertension is caused by my weight, rather than my PTSD. His notes do not address the issue of the one aggravating the other. I guess I'll appeal the decision, although I'm not sure how that process works, or really what I'll be able to say, or do, differently to help my case. Below is a redacted copy of the C&P exam notes, if anyone would be so kind as to offer an opinion and/or advice. It bears noting that in his remarks, he states that in 2009 I weighed 160 pounds and my blood pressure was normal. However, I thought 140/90 was the upper threshold of normal. The evidence he is citing reflects a reading of 142/86. Does the VA use a different criteria, because 142 is not normal by generally accepted hypertension parameters. Also, he states that the BP readings used to diagnose are not present, but I did the medical records from when I was diagnosed and they show a reading of 150/110 at that time. So, I would have to say that his statement is factually untrue, based on that the evidence that I submitted.
      Hypertension Disability Benefits Questionnaire Name of patient/Veteran: Shake-N-Bank Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No ACE and Evidence Review ----------------------- Indicate method used to obtain medical information to complete this document: [X] In-person examination Evidence Review --------------- Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS 1. Diagnosis ------------ Does the Veteran now have or has he/she ever been diagnosed with hypertension or isolated systolic hypertension based on the following criteria: [X] Yes [ ] No [X] Hypertension ICD code: 00 Date of diagnosis: 2013 2. Medical history ------------------ a. Describe the history (including onset and course) of the Veteran's hypertension condition (brief summary): noted to have high blood pressure and begun on medication on 2013. Had normal pressure in 2009 and weight of 160 pounds. b. Does the Veteran's treatment plan include taking continuous medication for hypertension or isolated systolic hypertension? [X] Yes [ ] No If yes, list only those medications used for the diagnosed conditions: lisinopril c. Was the Veteran's initial diagnosis of hypertension or isolated systolic hypertension confirmed by blood pressure (BP) readings taken 2 or more times on at least 3 different days? [ ] Yes [ ] No [X] Unknown d. Does the Veteran have a history of a diastolic BP elevation to predominantly 100 or more? [ ] Yes [X] No 3. Current blood pressure readings ---------------------------------- Systolic Diastolic Blood pressure reading 1: 138 / 82 Date: 8/23/2017 Blood pressure reading 2: 122 / 78 Date: 8/23/2017 Blood pressure reading 3: 126 / 80 Date: 8/2017 Average Blood Pressure Reading: 128 / 80 4. Other pertinent physical findings, complications, conditions, signs, symptoms and scars ----------------------------------------------------------------------- a. Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms related to the conditions listed in the Diagnosis Section above? [X] Yes [ ] No If yes, describe (brief summary): 8/11/2017 209 lb b. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis Section above? [ ] Yes [X] No c. Comments, if any: No response provided 5. Functional impact -------------------- Does the Veteran's hypertension or isolated systolic hypertension impact his or her ability to work? [ ] Yes [X] No 6. Remarks, if any ------------------ No remarks provided. **************************************************************************** Medical Opinion Disability Benefits Questionnaire Name of patient/Veteran: Shake-N-Bake ACE and Evidence Review ----------------------- Indicate method used to obtain medical information to complete this document: [X] In-person examination Evidence Review --------------- Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS MEDICAL OPINION SUMMARY ----------------------- RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: relation of hypertension to PTSD b. Indicate type of exam for which opinion has been requested: hypertension TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR SECONDARY SERVICE CONNECTION ] b. The condition claimed is less likely than not (less than 50% probability) proximately due to or the result of the Veteran's service connected condition. c. Rationale: The pressures used to diagnose hypertension are not available but apparently were there in 2013 when he was started on medication. He has gained nearly 40 pounds of weight since 23009. This is the most likely caused of his hypertension and the PTSD is less likely than not. ************************************************************************* /es/ FRANCIS M REMBERT MD
    • By Shake-n-Bake
      I just had two C&P exams this morning and am trying to keep a positive mindset, but the glass looks half empty to me. Maybe someone else can offer some insight on my situation.
      Since April, I have been rated at 60%; 50% for PTSD and 10% for tinnitus. The claims process for those went pretty smoothly, really, and I was awarded my disability ratings in very short time. I have since then filed three additional claims. My intent to file was back in April, but I submitted the claims on July 25. These three claims are for hypertension secondary to PTSD, sleep apnea secondary to PTSD and for hearing loss. Today I had my C&P exams for the hearing loss and hypertension. I have heard nothing about scheduling a C&P for the sleep apnea.
      My first exam this morning was for hypertension. I was diagnosed with hypertension, by a private doctor, about 4 years ago and have been on medication since then and am currently being treated by the VA for my hypertension. My hypertension isn't very severe, but it is outside of normal parameters and has been this way consistently for quite a few years. Even though I wasn't officially diagnosed until 2013, I have (and submitted) evidence of prior medical records that show high blood pressure readings well before my actual diagnosis. I don't think I meet the criteria for anything more than a 0% rating, but that's all I really want, or need. I believe I have bradycardia (abnormally low pulse), as a result of my high blood pressure. My blood pressure has always fluctuated and spiked in relation to my PTSD symptoms, so I certainly think the PTSD aggravates my blood pressure, but I don't feel good about my C&P exam from this morning. The doctor was one of the weirdest people I've come across at the VA, so it was hard to get a good read on him. All he did was take my blood pressure 3, or maybe 4, times, all from my right arm, while I was seated. He wanted to know when I was first diagnosed and how many times they had taken my blood pressure during the visit in which I was diagnosed. I told him it was in 2013 and, although I didn't recall how many times they took a blood pressure reading, I did remember how high it was when I was diagnosed. I tried to discuss the evidence I had submitted to support my having actually had high blood pressure before my 2013 diagnosis, but he shut me down. He said anything that I sent in with my claim wasn't his concern. All he was doing was "checking the boxes" on my blood pressure exam and someone else would look at everything that was submitted. This doesn't make sense to me. Isn't the purpose of the C&P exam to look at the evidence, as well render an opinion? I have already been diagnosed with hypertension and am receiving treatment. I'm guessing my blood pressure readings from the C&P exam are within normal parameters...that's what the medication is for. I don't understand the point of putting me through this dog and pony show, but I certainly didn't walk out of there feeling good about it.
      Next, I had my audiology exam for my hearing loss claim. I just had a audiology exam a little less than 2 months ago from a VA contractor and was subsequently issued hearing aids from the VA about a month ago. As I mentioned earlier, I already receive compensation for tinnitus, so part of me feels like the VA has already conceded that I had sufficient noise exposure in-service to cause damage, but I have also heard of people winning on tinnitus and losing on hearing loss. Since I had just recently had an audiology exam, I was only given an abbreviated C&P exam for my hearing. The audiologist stated that the contractor had not "submitted a full report", or something to that effect, so she only needed to do a partial test today. She asked me a little about my in-service noise exposure, as well as about my civilian occupations. It was over pretty quickly. I didn't feel quite as bad, or confused about that one as the hypertension C&P, but both of them seemed rushed and indifferent. 
      When I got home, I logged in to eBenefits to check on something unrelated and decided to look at my claim status. It had gone from Gathering Evidence to Preparation for Decision, since the last time I had checked on it. How could it be in Preparation for Decision? Mind you, I just had two C&P exams a couple of hours before. There is no way those reports had been sent in and considered already, so it had to have moved to Preparation for Decision a day, or more ago. Since I have not been scheduled for a C&P exam for my SA secondary to PTSD, I suspect now that they don't plan to give me an exam for the sleep apnea. The fact that they'd already moved my claim to Preparation for Decision before my exams leaves me with the impression that my claims are doomed to denial. Realistically, both the hypertension and hearing loss should each be rated at 0%, so that won't get me an increase in disability pay anyway, but a positive decision on the SA would. I also need the 0% ones, though, because of their relationship to other problems I have.
      I'm a little confused by all of this and am certainly not feeling hopeful about my prospects at this point. Am I jumping to conclusion prematurely, or am I making a reasonable conclusion that things aren't going my way? It's been less than 30 days since my claims were filed and it's already been moved to Preparation for Decision before my C&P exams. I don't know what that means, but it doesn't seem good.
    • By Michigander
      What impact do you think my MST/PTSD claim will have because I am not on any meds for anxiety or depression.  The only medication I was on was Xanax for my anxiety and panic attacks and my neurologist told me to stop taking my Xanax because I have such severe memory and concentration issues.  I am on a very low dose which he knows and that I needed to take the meds because it is the only thing to this point that helps my panic attacks or recover more quickly from one.  I am not on any depression meds. because I will not take them due to having suicidal thoughts when I tried them two times in my past.  I did think of killing myself...I had and "urge" to kill myself and that was the scariest thing to fight off for almost two days until my meds wore off.  I vowed I would never take those meds again (or any other class of the meds) I'd rather have my anxiety and depression than to kill myself and my children have to live with that the rest of their lives.  
      Now that I am filing for MST/PTSD I see the DBQ has many questions surrounding medications and it looks like in my situation the yes and no answers does not allow for the explanation above and my claim may be rejected despite my many issues I deal with daily that I am now in therapy for.  
      Any advice on what to do to address this preemptively for my claim??
    • By babs
      I just submitted my first claim for PTSD from MST. When I was overseas, I was on guard duty was an infantryman. When in a guard tower, he exposed his penis and started playing with it. He was looking at me and wanted to me "help" him out. We were locked and loaded so I was fearful on what this man was going to do next. I just froze. I told his SGT and he was detained and sent back to garrison. The rules changed and I was looked at a different way since the incident. There was no touching but this incident has impacted my life and my sense of security. I'm fearful of everything and what's worse is that it's now effecting my children and my marriage and that's why I'm now filing. I haven't talked about it openly with my friends and now I'm expected to talk about it with a stranger for my c&p appointments? Any advice on what to expect and how long the whole process take. 
    • By Andyman73
      Anybody have any idea or know anything about the part of the PTSD criterion relating to derealization and or dissociation? I experienced them both during my multiple MST events...still do.
    • By Tbird
      I saw the below on Stateside Legal's site and thought I'd share.
      Are you a man who has experienced unwanted sexual contact or touching? You are not alone. Join an anonymous online forum and hear from other men who have had experiences with unwanted sexual contact. See the attached handout and Safe HelpRoom for more information.
    • By tsphamwi
      Hey everyone I am new to this and I just filed my claim for PTSD/mst claim in january 2017 and I have been so stress out because I have been reading about claims being denied and low balled and such. My question is i just received my C&P exam which was done by VES. I got a copy of it from my Marine Core League organization. I had a question as to the exam results it says I am occupational and social impairments deficiencies in most area. and then it list the systems which I have symptoms from 70 50 and 30 percent and they are equal to each other. I am confused does that mean they are going to give me the 30 rating because there is no one percent more than another. I guess how can you be deficiencies in most area when I have symptoms from each percent. the exams stated that ptsd and mdd are aggravated from the military services. I guess do i not quality for the 70 or is pretty rare to be in 70 do you have to more on the 70 to be rated at that.
      he checked depressed mood, anxiety, near continuous panic or depression affecting the ability to function independently, flatten affect, disturbance motivation and mood, difficulty in establishing and maintaining effective work and social relationship, and inability to establish and maintain effective relationship. but he put me under the MDD recurrent severe, and mst. could someone please let me know what they think. 
    • By Andyman73
      This afternoon I have my C&P exam for PTSD secondary to MST, with a contracted provider. I found out Friday evening after work. Fed Ex had delivered the paperwork earlier, but I didn't get a chance to see it until I got home from work.
      To say that I am nervous would be the understatement of the year. I am desperately trying to hold myself together. My digestive system is all out of whack.  I did spend an hour on the phone last night with a wonderful person from a non VSO group. She is a Marine and has trauma history, so that made the connection pretty easy.  She gave me a lot of good tips, if I could only remember them when it's crunch time.
      One of my biggest fears is that this will be just like my previous mental health C&P...where that examiner, a VA employee, when straight for the jugular and ignored my heaps of physical evidence. I don't know why I am even doing this. I fully expect to get more of the same....nothing. If I do get granted SC, the shock of that may well kill me...because that goes against the grain of what the VA has given me over the years....tons of grief and denials.
      Anyway, just wanted to write this down as some kind of therapy...
      No body has to read it, or respond.  I'm not here anyway.........
    • By Michigander
      Need advice.  I do not have anyone helping me at this time with filing a PTSD/MST claim.  I do have a VSO appt. at a local vet center in a week or so.  In the meantime from what I have read you need three things to file a MST claim.  1. evidence (I have police report...check). 2. PTSD diagnosis, but you can also claim other conditions such as anxiety and depression etc...(right?).  3. Nexus letter.
      Please correct or add to anything above if I am missing something.
      My question today, is that although I just starting going to a civilian therapist a few months ago I have not disclosed my MST and have only talked about my daily anxiety, panic attacks etc....trying to deal with the problem without talking about the problem I guess.  When I decided to file a claim I thought I could start going to a VA mental health counselor to get therapy while at the same time getting diagnosed officially for my claim.  At this time, I do not have a document or official diagnosis of PTSD as my therapist has not told me that.  I did go to a therapist years ago who said I had PTSD, but she closed her practice and I cannot locate my records.   I know or guess it would have been better to have this long history of therapy for my PTSD claim, but I don't.   
      I ended up talking to a social worker at the VA last week who is the head of the MST dept. and although I fully intended to work with therapist there for my PTSD I am already not feeling good about working with the mental health staff there (without going into any details I just need to take another route). 
      My understanding is that I need the Nexus letter from a mental health person...right?  Does the Nexus letter come from a C & P exam or can you have a civilian therapist write it??  If you can have your civilian therapist write it I figure I would disclose my MST to her and start working with her in therapy then ask her to write the Nexus letter.  If I have up to a year to pull together my paperwork my therapist could write a letter a little further down the road once we discuss my issues related to my MST...right.
      I think I read it's best to go to a VA therapist to get a diagnosis and Nexus letter??... but I don't feel comfortable doing that.  If I understood what I read here...you may not need to have a C & P exam if you have the evidence and a Nexus letter...even if it's from a civilian therapist...is that correct?
      Anyways...sorry this email is all over the place, but hope it makes sense.
      Thanks in advance for your feedback!!
    • By MKAH
      Hello,  I am currently SC and rated at 10% Tinnutis & 20% bilateral hearing loss.
      Below is an examination and a review of that examination.  I am not sure how to interpret it?
      Thanks for any help reading it.
      Social Worker
      Signed: 06/03/2016 17:04
      02 Jun 2016 @ 0824
      Note Title:
      C&P Audiology 13294
      No CA Healthcare Sys-Martinez
      Signed By:
      Co-signed By:
      Date/Time Signed:
      02 Jun 2016 @ 0824
      LOCAL TITLE: C&P Audiology 13294
      DATE OF NOTE: JUN 02, 2016@08:24:04 ENTRY DATE: JUN 02, 2016@08:24:04
      Hearing Loss and Tinnitus
      Disability Benefits Questionnaire
      Name of patient/Veteran m…..Xxxxxx 1234
      Is this DBQ being completed in conjunction with a VA 21-2507, C&P
      [X] Yes [ ] No
      ACE and Evidence Review
      Indicate method used to obtain medical information to complete this
      [X] Review of available records (without in-person or video telehealth
      examination) using the Acceptable Clinical Evidence (ACE) process
      the existing medical evidence provided sufficient information on which
      prepare the DBQ and such an examination will likely provide no
      relevant evidence.
      Evidence Review
      Evidence reviewed (check all that apply):
      [X] VA e-folder (VBMS or Virtual VA)
      Page 18 of 44
      [X] CPRS
      This exam is for: Hearing loss and/or tinnitus (audiologist or
      non-audiologist clinician, using audiology report of record that represents
      Veteran's current condition)
      If using audiology report of record, date audiology exam was performed:
      1. Objective Findings
      a. Puretone thresholds in decibels (air conduction):
      | A | B | C | D | E | F | G |
      | 500 | 1000 | 2000 | 3000 | 4000 | 6000 | 8000 | Avg Hz |
      | Hz* | Hz | Hz | Hz | Hz | Hz | Hz | (B-E)**|
      | 30 | 50 | 75 | 85 | 95 | 105+ | 100+ | 76 |
      LEFT EAR
      | A | B | C | D | E | F | G |
      | 500 | 1000 | 2000 | 3000 | 4000 | 6000 | 8000 | Avg Hz |
      | Hz* | Hz | Hz | Hz | Hz | Hz | Hz | (B-E)**|
      | 35 | 50 | 70 | 80 | 85 | 105+ | 100+ | 71 |
      * The puretone threshold at 500 Hz is not used in determining the
      evaluation but is used in determining whether or not a ratable hearing
      loss exists.
      ** The average of B, C, D, and E.
      *** CNT - Could Not Test
      b. Were there one or more frequency(ies) that could not be tested: No
      c. Validity of puretone test results: Test results are valid for rating
      d. Speech Discrimination Score (Maryland CNC word list):
      | RIGHT EAR | 56% |
      XXXXXX, xxxxxx
      Page 19 of 44
      | LEFT EAR | 56% |
      e. Appropriateness of Use of Word Recognition Score (Maryland CNC word
      Right Ear:
      Is Word Discrimination Score available? Yes
      Word Discrimination Score appropriateness:
      Use of word recognition score is appropriate for this Veteran.
      Left Ear:
      Is Word Discrimination Score available? Yes
      Word Discrimination Score appropriateness:
      Use of word recognition score is appropriate for this Veteran.
      f. Audiologic Findings
      Summary of Immittance (Tympanometry) Findings:
      | | RIGHT EAR | LEFT EAR
      | Acoustic immittance | [ ] Normal [ ] Abnormal | [ ] Normal [ ] Abnormal
      | Ipsilateral | |
      | Acoustic Reflexes | [ ] Normal [ ] Abnormal | [ ] Normal [ ] Abnormal
      | Contralateral | |
      | Acoustic Reflexes | [ ] Normal [ ] Abnormal | [ ] Normal [ ] Abnormal
      | Unable to interpret | |
      | reflexes due to | [ ] | [ ]
      | artifact | |
      | Unable to obtain/ | |
      | maintain seal | [X] | [X]
      Page 20 of 44
      2. Diagnosis
      [ ] Normal hearing
      [ ] Conductive hearing loss ICD code:
      [ ] Mixed hearing loss ICD code:
      [X] Sensorineural hearing loss (in the frequency range of 500-4000 Hz)*
      ICD code: H90.3
      [X] Sensorineural hearing loss (in the frequency range of 6000 Hz or
      higher frequencies)** ICD code: H90.3
      [ ] Significant changes in hearing thresholds in service***
      LEFT EAR
      [ ] Normal hearing
      [ ] Conductive hearing loss ICD code:
      [ ] Mixed hearing loss ICD code:
      [X] Sensorineural hearing loss (in the frequency range of 500-4000 Hz)*
      ICD code: H90.3
      [X] Sensorineural hearing loss (in the frequency range of 6000 Hz or
      higher frequencies)** ICD code: H90.3
      [ ] Significant changes in hearing thresholds in service***
      * The Veteran may have hearing loss at a level that is not considered to
      a disability for VA purposes. This can occur when the auditory
      thresholds are greater than 25 dB at one or more frequencies in the
      500-4000 Hz range.
      ** The Veteran may have impaired hearing, but it does not meet the criteria
      to be considered a disability for VA purposes. For VA purposes, the
      diagnosis of hearing impairment is based upon testing at frequency
      of 500, 1000, 2000, 3000, and 4000 Hz. If there is no HL in the
      Hz range, but there is HL above 4000 Hz, check this box.
      *** The Veteran may have a significant change in hearing threshold in
      service, but it does not meet the criteria to be considered a disability
      for VA purposes. (A signi
      ficant change in hearing threshold may indicate
      Page 21 of 44
      noise exposure or acoustic trauma.)
      3. Etiology
      [X] Etiology opinion not indicated as:
      [X] Service connected condition
      [X] VBA did not request etiology
      4. Functional impact of hearing loss
      Does the Veteran's hearing loss impact ordinary conditions of daily
      including ability to work: Yes
      If yes, describe impact in the Veteran's own words: DIFFICULTY
      5. Remarks, if any, pertaining to hearing loss:
      1. Medical history
      Does the Veteran report recurrent tinnitus: Yes
      Date and circumstances of onset of tinnitus: FROM 2.16.16 EVALUATION:
      describes a subjective, bilateral, constant tinnitus with an unsure
      2. Etiology of tinnitus
      [X] Etiology opinion not indicated as:
      [X] VBA did not request etiology
      3. Functional impact of tinnitus
      Does the Veteran's tinnitus impact ordinary conditions of daily life,
      including ability to work: No
      4. Remarks, if any, pertaining to tinnitus::
      No response provided
      NOTE: VA may request additional medical information, including additional
      examinations if necessary to complete VA's review of the
      NIC…., MARK
      Page 22 of 44
    • By Michigander
      My heart goes out to all of my fellow survivors of MST ...
      For me, I have found I can no longer suppress and manage the daily physical and emotional affects of the sexual assault that took place on December 25, 1985 while serving on active duty.  In effort to find some help, relief and hopefully someday healing I am starting the uphill journey to deal with this and try to share some of the highlights of my battle.  I will be the first to admit I have no idea what I am doing and can only hope that God the father.... will guide my feet day by day. 
      First step locating documentation of the event.  A few weeks ago I was able to locate the police dept. and requested a copy of the report.  I received a copy of the 15 page report this past week and it makes me emotionally and physically sick just to look at the envelope it's in.
      I also tried to locate medical records over the years from prior mental health therapists and physicians that would have documented my history as it related to these events, but the practices were closed or my records were no longer available due to time.
      April I called the VA to inquire about mental health services for MST and hesitated to start the process because the MST would not be marked in my record for all my providers to see.  This was a big hurdle mentally as I have always hid this event at all costs from my providers.   I am sure this did not help my physicians treat me and fully understand my ongoing medical problems especially those in which are usually brought on by some big life event which I always adamantly denied when asked. 
      May 2nd 2017, I submitted a "intent to file".
      May 4th 2017, I went to a VSO rep?? to asked questions about the process to file a claim related to MST.  The rep was belittling, insulting, hurtful, rude and I walked out of that office with no more information and the psychological affects were pretty devastating.  At the encouragement from my daughter to go straight to the patient advocate office and file a complaint....I did just that.  I found myself have a total mental breakdown just trying to give the details of what just went down and was thankfully met with support and many reassurances that I would have a team of people helping moving forward and that person would be brought in...dealt with and re-trained.  I will spare you all the details.
      My next step is hearing from the mental health dept. to set up an appt. to do some type of baseline evaluation of my symptoms etc. as it related to MST... I guess to get an official diagnosis on record and to get me the specific therapy I need started.  I will likely opt for tele-therapy once I have a few sessions onsite at the VA. 
      That's it for now
  • Our picks

    • e-Benefits Status Messages 

      Claims Process – Your claim can go from any step to back a step depending on the specifics of the claim, so you may go from Pending Decision Approval back to Review of Evidence. Ebenefits status is helpful but not definitive. Continue Reading
      • 0 replies
    • I was rated at 10% for tinnitus last year by the VA. I went to my private doctor yesterday and I described to him the problems that I have been having with my sense of balance. Any sudden movement of my head or movement while sitting in my desk chair causes me to lose my balance and become nauseous. Also when seeing TV if there are certain scenes,such as movement across or up and down the screen my balance is affected. The doctor said that what is causing the problem is Meniere's Disease. Does any know if this could be secondary to tinnitus and if it would be rated separately from the tinnitus? If I am already rated at 10% for tinnitus and I could filed for Meniere's does any one know what it might be rated at? Thanks for your help. 68mustang
      • 15 replies
    • Feb 2018 on HadIt.com Veteran to Veteran. Sharing top posts and a few statistics with you.
      • 0 replies
    • I have a 30% hearing loss and 10% Tinnitus rating since 5/17.  I have Meniere's Syndrome which was diagnosed by a VA facility in 2010 yet I never thought to include this in my quest for a rating.  Meniere's is very debilitating for me, but I have not made any noise about it because I could lose my license to drive.  I am thinking of applying for additional compensation as I am unable to work at any meaningful employment as I cannot communicate effectively because of my hearing and comprehension difficulties.  I don't know whether to file for a TDUI, or just ask for additional compensation.  My county Veterans service contact who helped me get my current rating has been totally useless on this when I asked her for help.  Does anyone know which forms I should use?  There are so many different directions to proceed on this that I am confused.  Any help would be appreciated.  Vietnam Vet 64-67. 
    • 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
      • 14 replies