claim Reopening a PTSD claim

[bc0311]

I'm new to this site, and somewhat novice with claims as I've ignored them since my discharge in 2012, but I have some questions that I've yet to find answers for that hopefully someone can help me with:

In a nutshell, my story is I did my four years, two hellish combat tours to Afghan, got out in 2012, immediately filed my claims for a few disabilities like back and shoulder issues and got a 40% rating total. I've since not looked back as none of that concerns me. My issue now is that I was sent to a mandatory PTSD screening during one of my visits that year, and the examiner kind of went about the thing blase, and although I did tell her most of my traumatic experiences, she gave me 0% for "Combat PTSD not related to military service" as it says in their justification, whatever that means. I don't think they even attempted to listen to me as my experiences were extraordinarily traumatic and have been a detriment to my mental health and quality of life since. And yet I now have an effective date of a PTSD claim from day of discharge 6 years ago for 0%, says it right on eBenefits. I think you know where I'm going with this...

After 6 years of dealing with a slew of issues related to PTSD, I decided this week to start looking into trying to re open the case. My questions for you are.... Would I be entitled to any back pay if I could prove that I've suffered from PTSD since then, and that they made their original decision in error? And if so, how could I go about receiving the exact paper work / medical records from that one specific screening I had in 2012? I've looked everywhere and I don't really know how to navigate either of these situations... 

Thanks a lot!

[bc0311]

Not sure what that means. I imagine the examiners rationale was based on a binary questionnaire. Is that not kind of full proof?

What I find confusing is that I have 0% for bilateral hearing loss that's service connected. I'm deaf in one ear, but I'd need both ears for a rating. Why does that have a rating, even though it was not found to be a disability, and yet PTSD I have obvious criteria which she marked down, and yet that's not service connected. That doesn't make sense to me. Is that not grounds for a CUE?

[Buck52]

You have your evidence for your stressors  however it means nothing if your not service connected for PTSD. ( WERE NOT DOUBTING YOU )

  You need a PTSD DSM 5 DX from the VA themself (or proof you have it)  and then submit all your evidence , stressors are conceded for combat veteran  such as yourself,  you need to the PTSD Dx AND Dr's Opine  nexus this to your military service and then this type of evidence can be used in your claim.  that's just the way it is with the claims process we all have to do this.

  The PTSD C&P Exam is a  FORENSIC  Exam, the examiner will ask you some questions READ YOUR MEDICA RECORDS & MILITARY service Records, Look at your MOS ect,,ect,,, and determine your symptoms and categorized them in their severity  and  they will rate your symptoms REPORT ALL THIS BACK TO THE va   and the rater will  assign  10%  30%  50% 70%  or 100% depending on how severe your symptoms are.

Edited March 1, 2018 by Buck52

[bc0311]

I'm sorry but I don't understand what all the acronyms mean. DEM 5 DX...what? Opine nexus? Huh? 

So after a lot of digging I'm learning that a CUE is basically impossible. Like 99.99% of them fail. I think I have enough material for a new rating starting now. 

I guess I'm just wondering if you think it would be possible to CUE them on the fact that they decided this wasn't service connected at all. I used my hearing loss as an example. They gave me 0% but SC even though it didn't have bi-lateral hearing loss. Yet, the psychiatrist noted plenty of in-service stressors and a few symptoms yet still denied it was service connected. Would a reasonable mind not be able to tell this is an error? Should I even bother?

 

[Buck52]

As for has hearing loss  you have that S.C. AT 0% 

Now file for increase ..you will need medical proof your hearing has worsen by a Medial pro such as a licensed Audiologist using VA guidelines or use the VA for testing.

check this out.

A current diagnosis of a hearing condition,

Evidence of an event that caused the condition, and

A medical opinion linking the current hearing condition to the event in service or nexus.

Along with the list above, two types of tests are needed to prove a claim for hearing loss. These tests will include a controlled speech discrimination test (Maryland CNC) and a pure tone audiometry test. The Maryland CNC test is a particular word list that is used to test your ability to hear spoken words.  A pure tone audiometry test is different tones that must be detected at varying frequencies (low frequencies to high frequencies).  Even if you only claim hearing loss in one ear, both ears should be tested.  Examinations will be conducted without the use of hearing aids. This will prevent any biased results. These tests should be performed by a state licensed audiologist.

The VA will take the auditory test results and, use a numerical formula, to determine the actual rating that will be assigned. This formula can be found in Section 4.85 of the Code of Federal Regulations. Typical ratings for hearing loss are 0% or 10%, but severe or profound hearing loss can qualify for a higher rating.

[bc0311]

I was just using hearing as an example, I don’t currently care about it. 

They gave me 0% for a service connected disability that wasn’t a disability. 

For PTSD that was blatantly obvious they called it combat ptsd not related to military service. 

Is this grounds for CUE or no? 

[Buck52]

Correction that was DSM 5 which means Diagnostic  statistical Manual  with 5 # criteria  to be met.

The opine (opinion)/nexus is for a qualified Dr to render his/her opinion that your mental health PTSD Dx is likely as not caused by or related to your military service.

  They won't take our word for it just telling them we were traumatized while in the military,  we have to prove it and we do that with our military records all of them STR'S/ Medical records/service records, MOS, DD 214 our lay statment of the event in question and so on, Usually its  not so hard for a combat Veteran to prove his PTSD Status  but Dr's need to do that. 

I have 70% chronic PTSD from combat years ago from the Vietnam War and other disabilities that rated me 100% P&T with 3 SMC/s  all my combined ratings add up over 200% but the VA just keeps us at the 100% rating.

If you have any condition now that you think was caused by your military service  YES file a CLAIM  even your hearing  you can get a %for hearing loss more for profound hearing loss  they test both ears and can rate just one  depending on what the test #'s Show  you been S.C. FOR HEARING LOSS AT 0% that's the hard part  now you can file an increase on your hearing,  if its don't meet the VA Criteria for hearing loss at 10% or more  you will probably just keep the 0%  but noise induced hearing loss gets worse over the years.

Hearing loss is one of the hardest claims to win  unless your damn near deaf.