PTSD Re-exam after two years of being 70%

[Buck52]

What is required or to submit to keep the 70% PTSD if and when I may get called into a PTSD Dairy C&P?  (note:) I am not asking for increase!

What evidence Do they want? progress notes off myhealthyvet? 

Treatment sessions for two years? 

Will they take older records that I submitted for the original claim?

I think they may want to see if my PTSD has got better?

I think its still the same although therapy sessions have been every week and bi weekly now after two  1/2 years.  ( in therapy constant) never missed an appointment.

The only thing I can say is that I can sleep a little better than I used to because the meds knock me out  & a C-PAP Machine DX by VA AFTER I WAS DX FOR PTSD.

  but I still have flash backs  N/M's 3 or more times a week. & feel jumpi all the time and non-sociable in a sociable setting..but the therapist don't put that in his notes.

I always mention all this to him at my sessions.

So what do they (Examiner) want to look at besides my treatment notes? Will examiner let me speak up during the exam? usually they just read off the computer and make a decision.

I need to make sure I have the therapy notes in my favor that my PTSD is about the same? correct.?  I been DX  70% PTSD & Service Connected for it about 30 months now.

[Buck52]

Grumpbox yes I am 100% P&T with 2 SMC's

yes it (AB8)does state that No Future exams scheduled...and also no dairy date exam scheduled. the dairy dates says if the condition is of chronic and of nature and not expected to improve in my life time   and states   then no dairy date will be scheduled and it left that space where the dairy date should be if scheduled is blank. (no dairy date)

but the VA can scheduled an exam any time they want...were not safe until we have those 20 years in.

[Rocket1949]

Buck, what’s your status now? Are you scheduled for an exam? Have they given you any idea of a time frame to determine your status?

[Grumpbox]

@Buck52 OK Buddy!!  Thanks for the Tidbit! Seems as if the VA always has a spade they can use!  Good luck with things and keep us posted!!

GB Out...

[Buck52]

no not yet anywayz

I don't think I'll get a exam I am not scheduled to have one and have the condition is not to improve in my life time and its chronic in nature and I am over 55, unless  the therapist at VMC says I have Improved...which  don't think I have  

[broncovet]

While we have discussed this previously, I would like to set your mind at ease, Buck.  The regs are clear, as stated below.  The VA can NOT reduce a 100 percent P and T Vet UNLESS he has not only "actually improved" but has improved "under ordinary conditions of life".  While I dont have the newest VBM, I am virtually 100 percent certain that "ordinary conditions of life" means that you go back to work.  

The reg explains that a reduction is NOT warranted, for example, if your knees get better because you are not working and can stay off of them.  That is "not" ordinary conditions of life, because you can "baby" your knees which you could not do if you were working full time.  

Quote

 3.344 Stabilization of disability evaluations.

(a)Examination reports indicating improvement. Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and Department of Veterans Affairs regulations governing disability compensation and pension. It is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history. This applies to treatment of intercurrent diseases and exacerbations, including hospital reports, bedside examinations, examinations by designated physicians, and examinations in the absence of, or without taking full advantage of, laboratory facilities and the cooperation of specialists in related lines. Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction. Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psychotic reaction, epilepsy, psychoneurotic reaction, arteriosclerotic heart disease, bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest. Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life. When syphilis of the central nervous system or alcoholic deterioration is diagnosed following a long prior history of psychosis, psychoneurosis, epilepsy, or the like, it is rarely possible to exclude persistence, in masked form, of the preceding innocently acquired manifestations. Rating boards encountering a change of diagnosis will exercise caution in the determination as to whether a change in diagnosis represents no more than a progression of an earlier diagnosis, an error in prior diagnosis or possibly a disease entity independent of the service-connected disability. When the new diagnosis reflects mental deficiency or personality disorder only, the possibility of only temporary remission of a super-imposed psychiatric disease will be borne in mind.

(b)Doubtful cases. If doubt remains, after according due consideration to all the evidence developed by the several items discussed in paragraph (a) of this section, the rating agency will continue the rating in effect, citing the former diagnosis with the new diagnosis in parentheses, and following the appropriate code there will be added the reference “Rating continued pending reexamination ___ months from this date, § 3.344.” The rating agency will determine on the basis of the facts in each individual case whether 18, 24 or 30 months will be allowed to elapse before the reexamination will be made.

(c)Disabilities which are likely to improve. The provisions of paragraphs (a) and (b) of this section apply to ratings which have continued for long periods at the same level (5 years or more). They do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating.

 

[Hardway71]

On 3/13/2018 at 1:15 PM, broncovet said:

The "eg" above, means "for example".  This is important.  It does not mean you have to have phlebitis or heart disease to qualify under "diseases subject to episodic improvement".  It means ANY disease subject to episodic improvement.  

Let me give another example:  Depression or PTSD.  You do not have to have symptoms 100 percent of the time to obtain benefits for depression or PTSD.  Its not required you wear a tshirt which states, "I have PTSD" leave me alone.  NO.  A Veteran, when he goes for a c and p exam, reports his WORST symptoms.  Its fine to feel great on Monday, Tuesday, and Thursday, but on Wednesday you get in a fight with your wife because you have a flashback and she tries to wake you.  PTSD is quite episodic.  It would be rare for a PTSD Vet to experience PTSD symptoms ALL of the time.  Gee, I bet the PTSD Vet feels fine when he has a good time at his daughters birthday party.  No symptoms of PTSD then, but no reduction, either.  

@broncovet Great info posted here, and most appreciated!!  I was given a 30% SC rating for PTSD at my discharge from service in 2002... I was under rated. Took me until 2009 to get my gumption up, with the support of a group of great Vietnam Vets that I had met, to file a claim for increase. That was settled in 2012 when they granted 50% retro to July of 2009 and then 70% retro to September of 2009. That's where I'm currently still at, but I had a regular comp and pen exam for PTSD scheduled in June 2016 where they maintained my 70%.  The new kicker is that I got surprised with another comp and pen exam for PTSD that I just attended March 7th. I don't know why 2 exams so close together, and I'm sweating the outcome of this one right now. Doesn't seem right that the VA shoulcc be allowed to wreak so much havoc upon a vet's life with these ridiculous stressful exams when you're already just trying to keep your head above water.