kate7772

Talked with our VSO today and they did a reconsideration of the mental health claim stating an inadequate C&P. The VSO said that there are two main components of the C&P that are used when rating and the C&P examiner only completed one of them. VSO walked it to the VA regional office and it is already showing up in eBenefits as under review. VSO mentioned something about SEP. Anyone know what that term is? Hopefully they will agree to a new C&P. VSO said it is difficult to get a new C&P but due to the incompleteness of this one they think it will be granted. Kate

Yep. Nothing.

My husband's letter does not say anything one way or the other. So, I wonder the same thing. Maybe because he is only 90% and not 100? Kate

My husband is recently service connected at 90%. Which medical bills/prescriptions would be reimburse able? Only VA or private provider/pharmacy also? And how do we go about this? Thanks Kate

Talked with DAV today about coming in the file for TDIU and a NOD for percentage on mental health claim. They said there is a thirty day thing where we can request a conference with the rater and explain why we think the rating is wrong. DAV said they would be there also. Just needs to be done within thirty days of award. Anyone ever done this? Thanks Kate

The clinical psychologist who diagnosed him at the VAMC was not his regular treatment person. He was referred for a diagnosis by his nurse practitioner. Since beginning treatment, his treatment team has consisted of weekly/bi-monthly visits with a clinical mental health nurse practitioner, weekly sessions with a sicial worker specializing in PTSD therapy. As of this month, he is seeing a social worker for depression monthly and a suicide prevention therapist and a psychiatrist. Would it be acceptable to see an outside psychologist? I thought mental health had to be done at the VA.

Just before my husband's claim was decided, they moved his projected date way out. Then, it completed quickly. Kate

No inferred IU. Not sure why. The kidney C&P doctor did say " ability to work is limited due to edema". Only thing in packet was a form for rehabilitation. Going to visit DAV tomorrow. If he files for TDIU with the kidney disease and also. nod for the mental issue, would the NOD delay the TDIU claim?

He did not have a DBQ, just the C&P. This is what happened. We filed for PTSD and the kidney disease among other things. All were denied which, looking back was right because it was filed badly by the VSO we used at the time. We sent no evidence or anything. After the denial, my husband filed for reopen/reconsideration of the PTSD. We didn't file at the time for the kidney disease because we were waiting for a IMO. Once we received that, we filed a NOD for the kidney disease and requested a DRO. Filed the reconsideration for PTSD in May of 2014 and the NOD for the kidneys in Sept 2014. In November 2014 he had his C&P for PTSD, which was horrible. The examiner decided he did not have Ptsd without really questioning him much and also indicated he was overstating his symptoms. His reasoning was that since we have had a successful marriage for 40+ years and he held jobs throughout most of that time, he couldn't have PTSD. My husband's symptoms were severe and becoming more so. He did say my husband had an adjustment disorder due to the kidney disease and indicated a 50% level of disability. Since the kidney disease was not yet service connected, the adjustment disorder was denied. By this time I had gone from annoyed by everything to damn well mad. So, I emailed Allison Hickey and told her my husband was diagnosed by a clinical psychologist at the VA and had been undergoing treatment at the VA for over a year. So, how can this C&P examiner decide not? To her credit, ms. hickey got right on it and within a couple days we had calls from several offices and within another couple weeks a new C&P had been scheduled. This C&P was subsequently canceled and we got a call from a senior rater saying they would award the adjustment disorder based on the original diagnosis in the c&p. They would also award the kidney disease and schedule a C&P to determine severity for rating. That took place and the award quickly followed. But, it doesn't seem that they really delved into the treatment records (which have many references to all the symptoms. The c&p examiner did not state any.

His total rating is 90%. He would likely file for the TDIU on his kidney disease which is 80% and the reason he is unable to continue working. We were just hoping for the 70% for the adjustment disorder to bring it to scheduler.

We already have the rating for the Lejeune claim. 80% for kidney, 50% for adjustment disorder and 10 for tinnitus. So the referral for suicide prevention is not new and material in relation to why it should have been a higher rating? The fact that they did not include it or other symptoms in the C&P? It says in the award letter that a higher rating is not warranted unless the evidence shows.......and then goes on to list the symptoms and problems it must show. The medical treatment shows most of what they mention but they were never addressed I think largely due to the crappy C&P. My thinking was new on the recent referral to suicide prevention counseling which points to the fact that he has symptoms that they list as necessary for next higher rating. And of course material since it is their statement that it is an important symptom to have been rated higher.

Husband was recently awarded 50% mental health. We feel it should have been 70% and would like to reopen/reconsider. I know we need new and material evidence to do so. There are many symptoms in my husband's VA treatment notes that are in the 70% range but were never included in his very incomplete C&P exam. When asked. rater said they did consider the treatment notes but if so they sure missed a ton of references to all these symptoms. One of the symptoms is suicidal ideation. This is and continues to be an ongoing problem. But, since they said they considered the records, we likely cannot try to reopen with this. However, recently my husband's mental health nurse practitioner referred him to a suicide prevention therapist due to the fact that much of the treatment so far has been borderline helpful at most. He does not have an active plan but the thought is always there. So, would this referral be considered new and material evidence to reopen the claim and at that time we can refer to all the other overlooked symptoms also? Thanks Kate

80% kidney 50% mental 10%tinnitus

I'm not really clear on this. Are you saying to get an IMO? I would need to pay for one since my husband's doctor is afraid of his own shadow when it comes to stating anything. After the decision, I did contact the VARO director and stated about the treatment notes. He asked the rater to look at it again and she did and stated that the notes were used in her decision. If so, she definitely did not go by their own requirements for rating %. Could I possibly request a new C&p based on the fact that the original one was intended for PTSD and not the adjustment disorder the examiner decided on and he never included symptoms that would have included the ones required for a higher rating? If so, is there a law to site for this? I just want to get this right. My husband is 69 and health is not good. Don't want him to have to continue the craziness for years. Kate

Since VA is saying they considered the treatment records and I will not be able to now use them as new and material evidence, is there another angle to use to reopen?

How long does it take to get Voc. rehab either approved or disapproved?

Husband recently awarded 50% for adjustment disorder. C&p for this was originally for PTSD which the examiner decided was the adjustment disorder instead. Seem that when he decided it was not PTSD, he stopped as far as symptoms were concerned. He did not include a symptom list in the c&p. In the award letter, it listed the symptoms required to be at the next level. My husband has at least five of the eight symptoms and he is being treated for them and they are noted all through his treatment records. The rater said they considered the treatment records. If so, how could they miss the 70% mark? Would like to file a reconsideration/reopen to avoid the long time of a NOD. I know some don't like that option but it has worked well for us before and we have plenty of time before the year is up. But, since the VA says they considered the treatment records, obviously we cannot use that as new and material evidence. Is there another option? Also, we would like to file for TDIU but my husband just recently left his job. He tried working part time for two years after being diagnosed with kidney disease but even that became impossible due to edema and fatigue. The only medical statement he has to back that up is a statement from the c&p doctor that work Ability is limited due to edema. His kidney doctors office manager will not allow him to state anything due to legal fears. Would the c&p statement be enough? He is already on regular social security which he took early due to health. Then there is the fear of VA reducing the rating when something new is filed. Or is this unlikely due to the rating being so recent? Silly that veterans even have to worry about that.... Any thoughts on how to proceed? Thanks Kate

My husband just got 50% MH rating also and has suicidal thoughts all through his treatment records. But, from what I understand, actual attempts at suicide are not a requirement of 70%. I think so much depends on the Rater you get. Kate

I wonder if there is a way to see a list of those fired? I was in contact with a person at the appeals management center who seems to be MIA in the past week. Kate

Yes Berta, it is the water issue. The IMO, as well as a statement from one of VA's own kidney specialists, was very instrumental. I didn't notice a form for TDIU in the packet. Will check again. Do you think we will need a stronger statement than the one in the C&P I mentioned above? Is it bad that he just recently left his job? He held on as long as he could because of finances but reached the breaking point. Also, he has been on social security for about four years. Had to take early due to health. He is 69 now. Is he likely to qualify for SSDI? Thanks Kate

My husband's disability was recently awarded at 90%. Thank God for this because just before the award, he had to stop working due to his disability. He had been working only 16 hrs per week due to edema and fatigue caused by his kidney disease but even that became too much. His legs were so swollen by the end of a few hours that he could barely walk. He is over 65 and has been collecting regular social security for a couple years. He took is early because of the health issue and stayed working the limited hours. I'm wondering if he would be eligible for TDIU now. On the C&P, the examiner said he is limited in his ability to work due to the edema. Would he need a stronger statement? Thanks Kate

My husband's claim was officially awarded at 90% but it's clear from the monthly amount listed that I have not been included as a dependent. What is the quickest way to be added? Better to do online or have DAV do it? Thanks Kate

Congratulations. This has to take a lot of stress off your husband and you as well. I feel so bad for vets who don't have a dedicated spouse standing with them. Especially with mental health issues, it is so difficult for them to keep going. Kate

Yes it was. DAV says it is 80% for kidney and 50 for adjustment disorder. I do feel that the adjustment disorder should have been 70 due to the suicidal ideation. The C&P did not mention it but then again, that C&P did not mention anything because the doctor did not ask about problems, etc. it is all through my husbands VA treatment records though. Could that be considered a CUE? Kate