john999

Thanks Bronco I worry that as I approach my 20 year mark at current disability they VA will pull a fast one and call me in for a C&P exam. Most of the doctors I relied on for IMO's have retired. I still have one doctor who will help me. These doctors who will write IMO's for vets are a valuable resource and a shrinking resource I think. I don't trust anyone working at the VA or through the VA.

What is the best claim reference material these days? I have not filed a claim in a few years. I have an old vet benefits manual. What has changed in the last five years?

If you have 70% for major depression you can easily get TDIU which is almost as good as 100% rating. Are you able to work? The thing about depression is that is usually very treatable whereas chronic PTSD is not so treatable. The VA does tend to see many claims for mental problems as a claim for PTSD. If you get a rating for TDIU or 100% and you get P&T then you are pretty much home free. I would shoot for that goal is I was totally disable.

Get an Independent Medical Opinion to use as "new evidence". To continue to argue with the VA about these crummy C&P exams will just add years to your claim. Go out there and hire a shrink to review your records and draw an opinion that helps you. I would say without much doubt you can hire some decent shrink to do this. I got nowhere until I got an IMO.

If you want to win your claim within your life time get a IMP to refute the C&P exam. I have had numerous bad C&P exams and the fastest and best way to prevail is to get a strong C&P from an specialist to rebuke the original C&P. I have challenged bad C&P exams and it takes years to even get a new exam and then you will probably get another bad exam since you have no control of a VA exam. One you get your positive IMO you appeal or reopen your claim with "new evidence". As long as you can get new IMO's you can appeal. I got three IMO's on a claim for TDIU. I did not stop appealing and getting IMO's until I got TDIU P&T. It took a couple of years, but a lot faster than depending on VA exams. You just cannot depend on VA exams.

Since the VA considers chronic pain as a mental health condition I don't think you will get a separate rating for something like PTSD and Chronic Pain. They will rate it together under one rating. Now if you have a SC related physical condition and you have depression due to the chronic pain associated with the SC injury you can file a secondary claim for depression. You might get a better rating for the depression than for the original injury. I would advise any vet with a physical injury that limits his abilities to work or play to file a depression claim. Not many vets who are crippled up due to injury that do not feel with depression.

Are you getting TDIU? 100% money gives you a nice place from which to fight your battles. How much do you stand to win in retro if you prevail on the 1990 original claim. Just to win based on principle is not worth much if you can get 100% pay by merely filing a couple of reports and forms. If you think you can win significant retro then I advise getting a lawyer and get TDIU while you are at it if you don't have it.

COVA is not that veteran friendly. Even if you have the best lawyer in the land you are at a disadvantage because you no longer have benefit of doubt. COVA was not friendly to me and I had very competent representation on a CUE claim. I thought it was a slam-dunk and found out different. When you lose "benefit of doubt" and other concepts you get at lower levels in the system you are at vast disadvantage. If you can solve your claims at the lowest level possible you will save years of wrangling. In many respects the higher level vet appeals are a waste of time because they will swallow a whale and choke on a gnat. Save time and get your claim approved at the RO. Do what you have to do to get evidence and win it at the RO. All my claims were won at the RO by asking for DRO Hearings and getting new evidence to overcome VA objections. If it takes you years to win a ten percent increase at the COVA you have already lost by the delay.

Oh, yes, it has happened. The VA just denies claims sometimes because they know that at least 50% of vets won't appeal. I was denied for a heart condition due to AO. My VA doctor wrote a report for me that was golden, but the c&p "doctor" who was a nurse nixed it. I appealed and got 60%. It is weird because the denial was absurd and the appeal was absurd also. None of the decisions the VA made were logical but I won that round.

You know reimbursement rates for doctors who accept the VA payment for services is so low that most docs I know won't accept it. Medicare reimbursement is so low that the hospital system depends on private payers and insurance to survive. Medicade is the real joke. Reimbursement is so low for nursing home doctors like psychiatrists that where I live no doctor will make rounds except quacks. The Choice system will never work well because they need to make the VA a better payer than Medicare and you know they won't. I have Medicare and private health insurance so my doctors don't mind treating me. I do look at the difference between what the doctors charge and what they actually get paid.

The VA can really play hardball even with vets who have mental health treatment and DX in their SMR's. Persistence is the main thing with these claims. The VA has had a tendency to consider all psychological claims to be claims for PTSD. If you have treatment for mental health issues in-service this should be golden. However, be wary of the personality disorder DX. The military just loves to use that DX to disqualify vets from compensation.

Before I arrived at Hadit I did not know what TDIU was, but within 18 months of getting advice on Hadit I had TDIU. I had used the DAV and VFW for years and go nowhere. I would still be getting 30% rating if not for info I got on Hadit. You just have to make up your mind that you will not be denied.

If you are rated just 30% for MST/PTSD you have your foot in the door. I went from 30% to 70% and then TDIU in about one year. Getting SC'ed is the most important thing. It is usually a pretty long journey for most of us to get the correct rating, but it is worth it.

So you are trying to get an increase for your existing PTSD claim? I did not get that before. Only the VA can diagnose PTSD for compensation purposes but I think IMO doctor should be able to say it is getting worse. So you have had a C&P exam lately? I would say for that study the DBQ for PTSD. These VA guys do have check list they follow. Establishing the initial PTSD claim is the hard part IMO.

What about a Vietnam vet who is P&T and needing help with daily living? When does his spouse get care taker benefits? I remember asking the VA what if my spouse became totally disabled. They told me to put her into a nursing home and admit myself as well. I just don't know how it would work if your spouse is totally disabled and needs care with daily living tasks. How is a 100% vet supposed to do that?

If you are denied P&T in a rating decision you can appeal that Chapter 35 denial. I did that when I was granted TDIU but denied Chapter 35. I fired off my NOD and went and got another IMO which supported the P&T status. I got my P&T adjustment in less than a year. I was not wanting to wait years to get that rating. Any time the VA denies a benefit you can appeal and you should appeal. You can wait on the VA for years. I was eligible for HB and I had to file a CUE to get it. This is not supposed to happen and yet it happens all the time.

Back in the 1980's I filed for an increase for my mental health disability. The shrink I saw very skillfully lead me into talking about my childhood and high school etc. I had a rugged younger life and I was not a 100% advertisement for mental health, but I was not suffering from PTSD symptoms and all the other aspects from serving in a combat zone. When I got my rating decision I was denied an increase from just 10%. I was lucky that I had 10 years of a 10% rating or the VA would probably had terminated my total rating due to the horrendous C&P exam I had. The way he twisted my words I sounded like a career criminal. So as Buck and others have said avoid talking about the past or the future and focus on your military service and symptoms you are having directly related to your VA disability. I may be repeating myself but the VA can take a sentence and use it to dispute a 5 page IMO that seeks to grant you a higher level of disability. I know because they did it to me. The VA is really not a place to discuss your deepest thoughts and feelings. When you ask for compensation you enter a different ball game beyond just treatment.

Shreck Your past before the service is something you don't really want to bring up or dwell on when trying to establish a service connected disability. The VA has a tendency to look back at your unusual past and try to say that these pre-service events are what has been the major factor in your PTSD. These pre-service events are fine for therapy or treatment from a non-VA source. The VA in my day at least was apt to look at a person's past and make a diagnosis of a personality disorder instead of a genuine mental health issue like PTSD. This is why I say focus entirely on your military service. If you were exposed to horrendous events in the military this is what counts. Like you say the military accepted you as you were. You did not get a major psychiatric exam to determine your mental state before enlistment. In my time they drafted guys if they had a pulse. After the person had a breakdown due to stress the army would say you had a pre-existing disorder and the fact you were exposed to combat had nothing to do with it. I experienced all this crap back in the early 70's after Vietnam and I don't think the VA and military have really moved on since then. They do want to minimize any compensation they award with these phony PTSD cures.

As Buck says, get another therapist. If the person you are seeing now is minimizing your symptoms you can find someone who is not so blind.

Do you have proof the stressor event happened and that you were exposed to it? When I was in Vietnam I remember cowering in a bunker as tracer rounds whizzed over my head and also seeing dead bodies but some of these events were so common I can't even remember the dates or who was with me. I thought the whole 12 months might be a stressor but I was wrong according to the VA.

If you want to get help from the VA establishing a disability you need to be a compliant and "humble" patient. This means you have to cooperate with them even if you believe it is BS. Whatever you say can and will be used to mitigate or increase the severity of your disability. This to me is destructive of the therapeutic relationship, but if you want what the VA has to offer "play ball". Just be careful what you say to them and don't embellish the truth or tell any lies. If they catch you in a serious lie it will tend to haunt you forever. Of course, I am not saying you would do this on purpose, but just watch what you say to these VA angels of mercy. If and when you get the opportunity to "unload" don't hold back on details of your symptoms and sufferings. When a V shrink asks you a question they have a reason beyond just seeing how you are doing. Yes, I am suspicious as hell , but this is after 40 years of dealing with them. What events are you basing your PTSD claim on? Were you a combat vet or did you witness a horrible accident? This is usually what they want to hear. If you came into contact with dead bodies or injured people this is also a reason, but PTSD is individual and what affects one guy will not always affect another. In my day you almost had to have been badly wounded or in hand-to-hand combat to be considered as having a stressor.

This is tricky. I got HB based on Bradley V Peake. I had 70% IU and then got another 60%, but the VA did not immediately grant HB. I had to file a CUE to get it. I think if you can prove that you are, in fact, housebound due to your combined rating of 60% then you may be able to get HB "S". You will probably have to fight for it.

I had something called "calcification of veins and arteries" in my left leg. I filed a claim on this thinking it was PAD. The VA corrected me and granted a claim for CAD/IHD? I am confused about the difference between PAD, CAD and IHD, but I did get 60% on appeal. My first C&P was done by a nurse. It was an embarrassment to the medical profession. I appealed that baby and got 60%. This took a couple of years, of course. I got more testing at the VA's expense and the VA came back with some inconclusive results but I got the 60% for CAD anyway. I just don't understand how the VA came up with this rating but it gave me HB "S" so I can't complain too much. The VA really is not up to speed on this stuff.

I got SC'ed for CAD years ago due to AO exposure. All I was claiming was some blockage in my leg veins which had showed up on a CT scan done by the VA when I complained about it. I claimed this thing and some how the VA granted 60% for CAD. I was pretty shocked. My VA doctor at the time (8 years ago) did do a fantastic medical opinion like an IMO and I got connected. She was soon dispatched to some other VA job away from patients.

That just shows you how difficult it is to go back and attempt to revise old VA rating decisions no matter how much common sense is involved. This guy that Buck exampled was obviously low balled back in 1970, but because he did not immediately appeal his rating he was out of luck for the EED. For a vet to get a CUE that would grant an EED way back to 1970 is almost a miracle.