[VA IG on PTSD claim screw ups]

I put in for PTSD in 2019 with a QTC psychologist doing my private exam and the VBA put it in as somatic symptom disorder / chronic pain I did everything the 781 and buddy statements they just blew me off.

 

[VA IG on PTSD claim screw ups]

6 hours ago, Berta said:

PTSD vets need to read this- if they have a claim in process or have already been denied.

 

I think many denials might hold a valid CUE....... because of this report and 38 CFR 4.6.

 

In part:

 

 

"Claims processors did not request or verify the in-service stressor in an estimated 14,600 of the 18,300 claims. · Claims processors did not obtain a medical examination, medical opinion, or clarification of examination inconsistencies in the remaining estimated 3,800 claims."7

 

and "The OIG estimated that 6,300 of the 18,300 improperly processed claims resulted in errors

affecting benefits, totaling improper payments of $90.6 million to veterans.

10 The improper payments consisted of both overpayments and underpayments. If VBA continues to make PTSD

compensation claim processing errors at time of this review, future improper payments would total an estimated $271.9 million over the next three years unless VBA takes corrective action. 11 Claims Processors Did Not Fully Understand In-Service Stressors or the Stressor Verification Process During interviews with VBA staff, the review team had."   etc 

 

 

 

 

 Posttraumatic Stress Disorder Claims Processing Training and Guidance Need Improvement (va.gov)

Posttraumatic Stress Disorder Claims Processing Training and Guidance Need Improvement (govdelivery.com)

 

What a disgrace but not surprising.....

 

The VA has granted SC for PTSD to Wannabees, somehow over the years- who often are caught by the IG, or Dept of Justice, but at the same time, they (VA) are negligent in properly addressing valid PTSD claims.

 

This is a long report but I feel many here should read it----those 14,600 had no attempt by VA to verify their stressors and that is why it is often imperative for  veteran themselves to seek that proof.

 

A lot of these VARO claims people do not even have any idea of what military service is about,.and they caused one of my successful personal CUE claims.

They had denied my AO IHD death claim right off the bat saying the veteran ( my dead husband,) had no evidence of IHD in service.

SAY WHAT? I wrote a scathing CUE telling this idiot ( I sent it to the initials on the decision) 

that these combat veterans vets in the 1960s were still KIDS, sent to Vietnam,  and would have never gotten into service ,if their pre enlistment physical revealed heart disease,

and I rattled off 38 CFR.4.6 as told them this is the regulation they violated and that I expected a proper decision ASAP.

 

Three weeks later they awarded AO IHD death, due to the CUE , Section 1151 stroke (CUE pending on that), and also awarded a SMC CUE I had pending at Buffalo RO for almost 8 years. That's right- 8 years- 100% SC P & T PTSD and 80% (ultimately changed to 100% P & T for a Section 1151 stroke- an EASY claim to award)

 

What a system- snafued and fubared up the ying yangs----and, as I often say, literacy is probably not even a requirement  ,to became a paid VA claims adjudicator.

 

 

 

 

 

 

 

 

[Never told About disability]

Maxmus I have a very similar problem I was dx'd in service with Chronic Pain in 87 discharged in 93. Filed claim in 2012 for chronic pain was denied pain was not a mental disorder, filed again in 2017 denied same reason filed again in 2019 won at 70% the law changed in 2018 and so did the DSM-5 now they are calling it somatic symptom disorder. Now the twist in 2000 social security was granted for chronic pain and all the Doctors at my hearing were VA a psychiatrist and a neurosurgeon. Now the active duty part would require me paying a lawyer at $300 an hour to maybe get my discharge physical corrected then a board review even with malpractice law changes I will be long dead. So far an HLR refused to grant  even a 12 month earlier effective date let alone 2017, 2012 or the earliest that the VA knew of the condition 2000..When you think you are in the 5 digit or 6 digits for back pay a very good lawyer starts to make sense.  

[Never told About disability]

On 11/24/2020 at 11:22 PM, Maxmus said:

I was diagnosed with a mental disorder in 1988 and never told or treated and then discharged in 89. Filed for other issues that were denied and the VA tells me that a favorable finding is that I was diagnosed with this mental disorder. So I decided to put the other claims on hold and file for the mental disorder they diagnosed me with and never treated me for. My question is how should i pursue this and can I get effective date back to discharge since they never told me?

 

[Ankylosing Spondylitis, IBS D, and Irisitis/Uveitis]

 I was in Bahrain in the early 80s and some other sandpits was hospitalized 24 months later for GERD and diarrhea, that was in 1987. I hurt everywhere as time clicked by. My Gi doc 5 months ago found out that I had picked up Helicobacter pylori the damage done of the years can not be fixed but not being anemic and finally up taking fat soluble vitamins like K, D and calcium sure make you feel just a little more alive. They did not test for this until after two docs got the nobel prize in 2005 and the treatment is the same as amtrax it sucks but worth it.

[How to read C-PAP #'s]

On 10/7/2020 at 11:15 AM, Buck52 said:

Anyone know  just how to read c-pap numbers

I had to increase my air flow on my c-pap

But here is what the VA set them to in the beginning. (Jan 2016)

C-pap pressure 9.0 CM EPR FULL TIME

Apnea Index 0.9 Hypopnea Index 0.0 AHI 0.9

OBSTRUCTIVE :O.8  Central Unknown 0.0 

this was set about 5 years ago..I had to re-set these # since then because  I kept waking up at night..and I seem to think that the c-pap was not giving out enough air flow for me to sleep , so I adjusted the C-pap as to where the air flow was more stronger  and that seem to help with my sleeping.  so these #'s have changed (Right)

The VA SLEEP CLINIC is still is using these first #s they had set when I first got the C-pap.

in my medical records.

Google search OSCAR software for cpaps

 

[Packet that never arrived by U S mail.]

On 11/4/2020 at 6:48 AM, pacmanx1 said:

Anything is possible. Maybe the VARO said they mailed it and they did not.  Maybe the postman delivered it to the wrong address. Once a decision is made a veteran can contact the VA and have them to fax or email the veteran a copy after the ten (10) day mailing time.

I am currently in a remand status and the VARO sent out my SSOC the end of September and gave me a 30-day notice to respond.  In filling out my response, I contacted VA and was told to wait because VA had made a new decision the first week of October. I waited and waited until finally I called and said I needed to respond to the SSOC, and I had not received my new decision. Peggy then emailed me a copy of the decision and I faxed in my response to my SSOC with a few days to spare.  Never miss a suspense date or response time because that could kill your claim and effective date.

 

 

I never received one piece of paper from my 2012 first time claim, in the C-file last year it had a massive amount of copies of letters that never arrived. The address was correct but 2012-2014 was not good for the VA.

 

[How to read C-PAP #'s]

The major downside to CPAP therapy is that it can take some trial and error: your doctor may need to change the prescribed pressure a few times so that you use the most effective and comfortable setting but after that they are done with us. I have had a cpap for 20 years and have found the interaction with sleep medicine doctors to be lacking. Thanks to the new advancements in computer chip usage you can take more control over treatment plan. Over time, we have health changes, changes in medications, new pains or operations and over all changes in life all affect sleep. I was having huge problems with worse pain and increasing pain medication after I got the sleep program OSCAR and started downloading the sim card from the cpap and learned just what it is showing me. I then had to buy a O2 monitor that had an alarm to wake me up if my O2 dropped below a set point. When we go to a doctor and try to explain we are feeling worse after that medication change they tend to say keep taking it will go away. Walk in with the charts of before the change and after reading the hard data they start talking. In my case the stopping the new pills that had my O2 dropping to 74% was back to 90% drops in two days and I started to  feeling much better. Have not taken those pain medications since and am now working with a ENT to fix issues with my nose and TMJ that would have never been addressed. But if you are having to battle the cpap and your doctor and sleep doctor are not helping find a different sleep doctor. Good for you wanting to know what those numbers mean.
Source: https://www.talkaboutsleep.com/sleep-apnea/

[Had Degenerative Disc Disease Changed To Lumbosacral Sprain]

On 5/21/2018 at 11:28 PM, Richard Ballard said:

OK so I had pancreatectomy in 2003 due to an impacted goldstone 2/3 of my  Pancreas was removed I am type one diabetes with very large scars continued diarrhea stomach problems Constant back and shoulder pain I recently received a Nexus letter from my  endocrinologist related to my service in the gulf war.  Any suggestions or advice from anyone

Wow,  I hate this I had my pancreas damaged in service was in the hospital for a month in 1987 and still not given a rating for the hell I have gone through, thanks to one navy surgeon not completing his paper work. I refused that Whipple procedure. You may want to research bone loss due to steatorrhea diarrhea plus heart disease from hyper high trigralites and LDL/HDL if you can service connect. If you had RUQ pain in service you have a wonderful chance. 

[Had Degenerative Disc Disease Changed To Lumbosacral Sprain]

I am at a loss at how to claim my entire spine in one claim. I had arthritis in my knee in service and was to be med boarded, but was not. Have complaints of back pain after 10 months of being on couches in service as I was being returned to full duty. I have over 20 years of VA x-rays, MRIs and CTs showing how the curve in my lower back and neck have vanished with the common L5/S1 an C5/C6 nerve damage.  I made the mistake of allowing the VA to do two shoulder surgeries in one they took part of my bone and had it tested and it can back as reactive arthritis.