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Adjudication for a PTSD MST Claim

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Osccore9

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Hello everyone,

I had my first C&P exam today. After I finished with the examiner, I went home a little confused. Two hours later, my examiner called me stating that my claim, because it was under special circumstances (MST Claim) was going to be a adjudicated by the VA. My question is, what does this mean? Thanks in advance.

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I find it very unusual that the examiner called you.

What disability did you claim?

There is much info here on MST claims.

I hope you have copies of your SMRs and Military Personnel Records.

If the exam was done at a VAMC, their FOIA/Privacy Act Officer can get a copy of it for you (they have a brief form you need to sign) or you can request that by mail.

If the C & P was done by a non VA contractor, VA will not release it until they make a decision.

You can obtain SMRS etc at www.archives.gov. Make sure on the SF 180 form that you request all of your personnel records too because changes in service due to MST and requests for transfers etc, all support MST claims.

Of course if you reported the MST after it happened that evidence also should be in those records.

 

 

 

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Hello Berta,

Thanks for the reply, I appreciate your input on this matter. I found it a little strange as well that she would call me 2 hours after the initial exam. As for the C&P exam, it was done by one of the doctors at the VA Loma Linda Hospital. I came home after the exam and checked ebenefits, and my status went from gathering evidence to making a decision stage in a matter of hours. Is it unusual that a status can change literary a few hours after the exam took place?  Also, what are SMR's? How long do I have to wait till I can request the records of my C&P? Thanks in advance.

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That is an odd status...then again ebenefits is not always accurate or dependable.

SMRs  aka (STRS) Service medical/treatment  records

and this is unusual too that the doctor stated 

"under special circumstances "

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Berta,

She called me and left a long voicemail about how the VA was adjudicating my claim. I have no idea what this means. Also, when she conducted the C&P exam, she asked very brief questions. Never really asked me about the actual incident, didn't ask me about any current symptoms or anything. At the end of the exam, I asked her if she was going to conduct a  REVIEW POST TRAUMATIC STRESS DISORDER (PTSD)  DISABILITY BENEFITS QUESTIONNAIRE, and she said, "I normally would, but I have done over 10,000 today already, so I wont be doing one at this time with you. At that moment I felt like my claim was in jeopardy. I asked her what the diagnosis was, and she stated, " oh you definitely have PTSD, and changed the topic right after.  I really hope everything goes well. As for my medical records, they are all under the VA. I have been getting treatment from them since 2014. My First Sergeant at the time took me to the emergency room due to suicide attempt caused by MST. The VA has all those records.

Edited by Osccore9
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My take on this is to wait and see what the doc actually wrote in the report, and not rely upon what they tell you. 

After you read the report, you can post portions of it if you still want advice. 

If you get the C and P exam report, and if its inaccurate, you can challenge errors in your exam.  YOu need not wait for a decision.

1.579 Amendment of records.

(a) Any individual may request amendment of any Department of Veterans Affairs record pertaining to him or her. Not later than 10 days (excluding Saturdays, Sundays, and legal public holidays) after the date or receipt of such request, the Department of Veterans Affairs will acknowledge in writing such receipt. The Department of Veterans Affairs will complete the review to amend or correct a record as soon as reasonably possible, normally within 30 days from the receipt of the request (excluding Saturdays, Sundays, and legal public holidays) unless unusual circumstances preclude completing action within that time. The Department of Veterans Affairs will promptly either:
(1) Correct any part thereof which the individual believes is not accurate, relevant, timely or complete; or
(2) Inform the individual of the Department of Veterans Affairs refusal to amend the record in accordance with his or her request, the reason for the refusal, the procedures by which the individual may request a review of that refusal by the Secretary or designee, and the name and address of such official.
(Authority: 5 U.S.C. 552a(d)(2))
(b) The administration or staff office having jurisdiction over the records involved will establish procedures for reviewing a request from an individual concerning the amendment of any record or information pertaining to the individual, for making a determination on the request, for an appeal within the Department of Veterans Affairs of an initial adverse Department of Veterans Affairs determination, and for whatever additional means may be necessary for each individual to be able to exercise fully, his or her right under 5 U.S.C. 552a.
(1) Headquarters officials designated as responsible for the amendment of records or information located in Central Office and under their jurisdiction include, but are not limited to: Secretary; Deputy Secretary, as well as other appropriate individuals responsible for the conduct of business within the various Department of Veterans Affairs administrations and staff offices. These officials will determine and advise the requester of the identifying information required to relate the request to the appropriate record, evaluate and grant or deny requests to amend, review initial adverse determinations upon request, and assist requesters desiring to amend or appeal initial adverse determinations or learn further of the provisions for judicial review.
(2) The following field officials are designated as responsible for the amendment of records or information located in facilities under their jurisdiction, as appropriate: The Director of each Center, Domiciliary, Medical Center, Outpatient Clinic, Regional Office, Supply Depot, and Regional Counsels. These officials will function in the same manner at field facilities as that specified in the preceding subparagraph for headquarters officials in Central Office.
(Authority: 5 U.S.C. 552a(f)(4))
(c) Any individual who disagrees with the Department of Veterans Affairs refusal to amend his or her record may request a review of such refusal. The Department of Veterans Affairs will complete such review not later than 30 days (excluding Saturdays, Sundays, and legal public holidays) from the date on which the individual request such review and make a final determination unless, for good cause shown, the Secretary extends such 30-day period. If, after review, the Secretary or designee also refuses to amend the record in accordance with the request the individual will be advised of the right to file with the Department of Veterans Affairs a concise statement setting forth the reasons for his or her disagreement with the Department of Veterans Affairs refusal and also advise of the provisions for judicial review of the reviewing official's determination. (5 U.S.C. 552a(g)(1)(A))
(d) In any disclosure, containing information about which the individual has filed a statement of disagreement, occurring after the filing of the statement under paragraph (c) of this section, the Department of Veterans Affairs will clearly note any part of the record which is disputed and provide copies of the statement (and, if the Department of Veterans Affairs deems it appropriate, copies of a concise statement of the Department of Veterans Affairs reasons for not making the amendments requested) to persons or other agencies to whom the disputed record has been disclosed. (5 U.S.C. 552a(d)(4)) (38 U.S.C. 501)
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Bronco,

I appreciate you taking the time to reply to my post. I was really disappointed in my C&P exam. I guess the only thin that keeps my hopes up is that the Doctor told me she would write the best review possible. I just don't understand why she didn't go through the proper procedures.  QUESTION. Where can I access e records for the C&P exam?  Thanks in advance.  

Edited by Osccore9
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