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El Train
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Posts posted by El Train
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Pretty sure the original poster has left the forum shaking his head. Can we stay on topic?
If I was original poster, there is no reason to file for TDIU. If the VA determines he's TDIU, it is what it is. Sounds like they can't work anyhow. I'd prefer the opportunity to work in limited environment/capacities (which I do) and not have TDIU. TDIU may take this away from you.
First off, he needs to be approved for TBI. He is not. All this talk about TBI-T is for naught. The VA is supposed to assume TBI-T if his situation is bad enough. We all know this would have to be a case of 24 hour nursing home care and bedridden (worse case scenario). So get the TBI approved, then go after TBI-T. As it stands now, communicating in a logical way on a forum probably disqualifies the VA assuming TBI-T. As it should. But that is a fight fought later down the road.
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So you are not service connected for TBI? I am service connected 100% PTSD/TBI. My TBI alone would have put me at 70%. The PTSD was 100% so they went with the higher of the two and combined. I did get a seperate rating for migraines. If you are filing for a TBI claim, be prepared for a litany of C&P exams to seperate overlapping symptoms. It's a long road and I think you better get your TBI claim approved before thinking about TBI-T. That's a very high hurdle to get. I may pursue it in the future since my symptoms are gradually getting worse with age. Pre dementia level.
Do you have VA approved caretaker? Pretty sure that is a requirement step for TBI-T.
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Ridiculous you can't easily get a copy of a contracted C&P in a timely matter. They could at least send it with your decision letter. Then the one year time line to disagree with it starts when you get the decision letter. Luckily, I was able to get mine fairly quick with a FOIA prior to covid. I was able to complain to the VARO about a bad C&P examiner prior to getting a decision.
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On 2/5/2023 at 8:21 AM, Whodat said:
The VA forces vet to have and IMO but they are also aware that Vets will pay big money to get one then turn around and deny the claim for something as to how long the doctor have been treating the Vet. That's part of the IMO. Why pay for an IMO these days.
True, but the C&P examiner isn't my treating Dr. either. They have the same evidence. In my case the Dr. I paid to do an IMO trained C&P examiners on how to conduct exams. Another one I had, was a former C&P examiner with over 20,000 exams under his belt. Both of their exams were written way better than the VA examiners paid guns.
My initial scars claim went from 10% to 80% after I filed an NOD with this additional evidence. My PTSD/TBI went from 50% to 100% P&T. It does suck that we have to do this, I will give you that. It did work out in my favor.
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In my case, I challenged a contract VA's Psyc. Dr. vs. my Psyc. Dr's C&P exam. I wrote up a letter challenging the C&P examiners bias, mistakes, and differences between my outside medical IMO and the VA's. I then sent it to my regional VARO. I googled it, got the name of the head honcho and addressed it to her. Her C&P exam was biased from the start when I handed her my outside Psyc. Dr's DBQ and IME. She was not impressed and her exam reflected her disdain. So that was easy to point out. Not only that, but I had multiple C&P exams trying to separate PTSD & TBI symptoms in my favor. She was the lone negative exam. It got tossed.
I don't see why this route wouldn't work to challenge an NP's opinion vs an MD opinion. It would at least get you another C&P exam. If they did that, the next C&P examiner would know about the complaint. Not a bad thing. That's how I got the bad C&P exam tossed.
I think this route can save you years in the appeal process.
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2 hours ago, Riplip said:
Well my VSO said my C&P from the NP at Optum Serve is negative. I guess they "developed to deny" with me on 3 C&Ps for the same thing and having a IMO from an actual Doctor. Funny how a NP out weighs a DR. Looks like a very long appeal process is in my future. The VBA really does suck and they are not for the veteran (IMO). I hope others get better news.
Yes, I had a VA NP (general practitioner) overrule my forensic DR's IMO. The VA sided with their NP's opinion and denied. I could've fought it and surely would've won. Fortunately, she sided with most of the forensic DR's IMO's and I was awarded 100% P&T SMC-S. So it would've been futile to do so. You can challenge her credentials with your local VARO. I've done this with success. They redid a few C&P exams that went in my favor.
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IDK about DR. shopping. I've always gotten a fair shake from contracted C&P examiners. One exception is when I pissed one of them off, that didn't go my way. This resulted in several more C&P exams when I complained about the bad one to the regional VARO. The additional C&P's (QTC in my case) all went in my favor. I had outside DR's opinion (Yes, I went DR. shopping) that helped out and evidence on the record.
If it's a complicated case like PTSD & TBI, you can expect multiple C&P exams. How you handle the repeated exams from different examiners is up to you. I suggest go through the motions and let the chips fall where they may. In my case, 100% P&T with SMC-S. I hope the best for you. Getting all fired up or refusing to go to exams isn't going to hasten things. Do what you think is best though.
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Ya, I love the skip the question and check 'no' move. When I filed a complaint to the VARO about the skipped questions, the subsequent C&P examiners asked every question on the DBQ. So they knew what I complained about. One examiner even said, 'so it looks like a previous exam didn't go so well'. I told him it probably had to do with me pissing her. That was an ice breaker with the guy. He was on my side after that.
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2 hours ago, capitan said:
It makes no difference how long ago it was. She acknowledged she filled the DBQ out. She clearly didn't record some of the entries accurately which resulted in a 0% rating, which should have been 30%. Unfortunately, transparency, accountability, courtesy and respect are foreign concepts to her.
Try to get a copy of the DBQ she did on you. Then you can see exactly what she filled out. If you don't agree with it, then you can file a complaint with your nearest VARO. I did this when I got a bad C&P exam. It triggered several more C&P exams that we're done correctly.
Now I will tell you this, I did piss off the C&P examiner that resulted in a bad DBQ. Don't do that. It won't go your way.
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44 minutes ago, qwiksting said:
This is my mindset...just leave me alone and refill my scripts. I do not leave the house with the exception to seek healthcare or go to group at the vet center. I don't like crowds and don't have patience for stupidity. Just leave me alone. This is one of the problems I am having with this NP. An appointment every 3 months? Like, I have been on my meds for 18 years or so? It just feels weird. I get a 6-month visit, but 3? When I see her in April, I am going to bring this up. I get more out of the VET center. To me, she is nothing more than a medication manager.
I still have a question about the typed out memo I gave her at my first visit. Why it did not make it in my records? Should i try again when I go in April, or should I try and submit it at FOI on my own?
I wouldn't mess with the memo. They're not going to reevaluate you. I'd be straight up with her. Just let her know you want to just stick with the vet center. She's getting your scripts filled through the pharmacist anyway. Ask her if they can just call you every 3 months, or have your PCP do it. Especially if you have been on the same ones for 18 years. I found meds made things worse, so I quit taking them. If they work then stick with them.
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I haven't seen a MH provider in 4 years. She retired and I just never did another appointment. I had a MH pharmacist call every 3 months for awhile to re-up me on meds. Then he quit calling. My PCP re-ups my meds now.
I prefer to be left alone honestly. I'm 100% P&T for PTSD alone. I still work a sheltered environment job. I do the best I can. I'm not worried about a reduction but I'm not going to put in any more claims. I have quite a few lowball ratings like you. Nothing that will kill me that I know of. I'll be at my 5 years later this year.
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7 hours ago, leebenjamin said:
The exam is focused on evaluating the impact of your PTSD on your daily life and functional abilities. While alcohol usage may be relevant in some cases, it's not always necessary to disclose it.
I mean your advice is appreciated and good. But this post is over three years old.
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I mean, why not send the C&P exam results with the decision letter? They've reviewed the exam that led them to their decision, so they have it. The clock starts ticking when the packet has been received via priority mail (the Veteran signed for it). I've had decision packets not show up. It happens. Problem solved.
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I have had a VSO get copies of contracted C&P's. I don't think it's that easy anymore. It might not even be legal for them to get them for you. IDK. You do have to file a FOIA to get them if they have been done by a contractor. It does suck and it takes time to get them. Sometimes they won't release them until your claim has been finished.
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TBI 'should have' resolved itself. There's the variable. It easily could read TBI 'may have not' resolved itself, if you still have symptoms. They don't know. Did you do a C&P with a Psyc. Neurologist Dr? Did they do the MOCA test? That's how they will rate you for a TBI. It depends on how poorly you did in any of those test categories. In my case, I did poorly on one of the categories. That put me at the 70% rate for TBI. BTW, I had four or five C&P exams for TBI and PTSD. They were trying to separate all the symptoms. It's a complicated process.
I had two IME from outside Dr's that helped out my TBI claim. One by a forensic MD and one by a Psychologist.
If you haven't got a copy of your C&P exam, I would do that.
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This happened to me when I first applied. Didn't qualify because of income. A friend told be this was BS since I was in the Gulf War. He suggested to apply for VA disability as well. A year and a half later, I'm in group priority 1 and 100% P&T. All health care covered.
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Why is your VSO wanting to put in for PTSD? Do you have that diagnosis or getting treatment from the VA or outside the VA? PTSD is pretty specific. You had some sort of documented event in the military that caused PTSD and you are getting treatment for it. If you are getting treatment for it (meds, cognitive behavioral therapy, etc.), then it's basicly a new claim, if granted will be combined with your adjustment disorder. It will require treatment along with meds from the VA. The C&P will grant the diagnosis based on treatment records. You will need a stressor incident (witnessing death, near death experience, combat action medal, etc.). They will investigate this stressor unless you have a combat action award, then it is presumed. If you have no treatment for PTSD but another mental condition, I'd just put in for an increase on your current 30% adjustment disorder. I have a friend that has 100% due to anxiety alone.
PTSD can be granted years or decades after service, other mental conditions are way more difficult from what I understand. PTSD can have delayed onset.
BTW, you would be surprised at how many VSO's just aren't very good at what they do. Mine had 25 years experience. I handled most of my own claims. When the dust settled and I got 100% P&T, SMC-S, that dude was asking me for advice. They're good at getting records, submitting evidence, and answering basic questions. He told me I had slim and no chance on some claims I wanted to apply for that I got approved at maximum rating.
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I'd be afraid they claim to find an error in some of my ratings and reduce. I have some very high ratings that I was even surprised to get. If I was close to 100% or smc, then I'd go for it. But I'm both of those.
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On 12/30/2022 at 6:44 PM, Cbski76 said:
Main point of my post is that a SMC level can be obtained while you are still able to work but you have to have the right percentages in your favor.
That is a lot for a 'main point'. I'm not saying it's impossible to get SMC-T. I mean it would take a raters error for him to get it. That's a stretch at best. He doesn't rate smc-t. He has to be in constant nursing home care with 24/7 care. Not his wife at home. Working on top of that? I mean I looked into it myself, but I'm only at 70% tbi. Ain't gonna happen. We're on here posting with a some logical thought process. A person that rates smc-t shouldn't be able to do that.
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20 hours ago, brokensoldier244th said:
You can have a 0% rating for a condition.
I know, I have 0% for hearing. But for GW presumptive, I'm certain it has to be at least 10% disabling or more to get it granted. Another rater on the other site stated this as well. An error.
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I have the same rating as you (Fibro 40%, IBS 0%, gulf war stuff). The 0% is an error since it has to be at least 10% to be granted. Mine should be higher than the 0%. I'd fight it but I'm 100% P&T, SMC-S. If you're less than 100% I'd file for an increase. You can have both Fibro and IBS rated. Now CFS is a different story. Got denied due to Fibro and PTSD.
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It's saying I'm not eligible since I didn't apply within two years of my last service connection.
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It is great. Except you been losing an extra $400 since inflation reared it's ugly head for last two years. Nice to level it out a bit. Except the price's will continue to rise, eating into it more. But ya, it's going to help.
- ShrekTheTank and Vync
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On 4/5/2015 at 10:54 PM, crazyhorse3022 said:
Anyone receiving smc for tbi n residuals.
Good chance they won't be replying if they are. Maybe someone knows someone with it. It's not an easy claim to be granted. And those with it, would gladly give it up to lead a somewhat normal life.
Va has me confused.
in Appealing Your Veterans Compensation Disability Claims NOD, DRO, BVA, USCAVC
Posted
Have you got your decision yet? Have you read the C&P exam? I mean I've had C&P exams I felt went bad, turn out in my favor. And vice versa.