Ruffcreek

I received a rating of 50% for PTSD in 2006. (This has been recently increased to 100%) I submitted a claim for sleep apnea secondary to and/or aggravated by service connected PTSD on October 23, 2007. On my recent decision this is what they wrote: Service treatment records do not show treatment for or dianosis of sleep apnea in service. The medical report from DR.XXXX relates that your sleep apnea was aggravated by your PTSD. Copies of sleep studies you submitted shwo that you are currently on a CPAP machine at night. VA respiratory examination was normal. The effective date is October 23, 2007, the date of claim. Service connection for sleep apnea has been granted because this condition, which was not incurred or aggravated in military service, permanently worsened as a result of a service connected condition. The difference between disability evaluations before and after military service determines the degree of disability subject to service connection. Prior to aggravation by a service connected condition, the disability was considered 50% disabling based on evidence that showed you had obstructiive sleep apnea and were placed on a CPAP machine. Following aggravation, the total disability is 50% disabling because this evaluation granted for being on a CPAP machine. The preaggravation percentage is always deducted before assigning any service-connected evaluation less than 100%. So as the preservice aggravation was 50% disabling and the current condition is 50% disabling, service connection for sleep apnea as aggravated by your PTSD is granted as 0%. Your current condition does not meet the criteria for the 100% evaluation as shown below. The rating criteria for sleep apnea is: An evaluation of 30% is assigned for persistent day-time hypersomnolence. A higher evaluation of 50% is not warranted unless a breathing assistance device, such as a continuous airway pressurer (CPAP) machine, is required. A higher evaluation of 100% is not warranted unless there is chronic respiratory failure with carbon dioxide retention or cor pulmonale, or a tracheostomy is required." If anyone can clarify for me what they are saying about how they are figuring the %, I would appreciate it. Thanks, Ruffcreek

Thanks for everyone's help. Berta. Her are answers to your questions. I failed to NOD the 2006 claim within a year so I've lost this option. Also I would not be able to present any evidence submitted in 2006 that they disregarded. The 100% decision does not refer to the 50% decision. I may consider filing a CUE. Note: The reason I received 100% and not P & T is the C & P examiner made the statement that "he is still early in treatment so is not possible at this time to make a realistic assessment in our treatment might diminish the present high level of PTSD symptoms." (I had been receiving treatment at the VA for only 2 months at the time of the C & P exam) My plans are to get a letter from the director of the PTSD clinic and have her write a letter stating that my disability is permanent and total. (if possible) Any other strategy on this or what I should or shouldn't do please let me know as I'm kind of in the clouds on this. I will be applying for SSDI today. Ruffcreek

Congratulations!! My next step is the SS. Ruffcreek

I was recently awarded 100% for PTSD (HAPPY). I was paid retro to 2/27/08, the date I submitted the claim for an increase from 50%. My original claim in which I was awarded 50% was submitted July 2006. 38 CFR 4.7 says "where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned." Dosen't this give me grounds for filing a NOD requesting the higher evaluation of 100% back to July 2006?

Thanks everyone..I do appreciate it!! Ruffcreek

Congratulations!!! Ruffcreek

Congratulations!!

On Monday I received an increase from 60% to 100%. (Not P & T but still happy) Thanks for all the help and encouragment from everyone at Hadit. Will have a couple of questions on a different forum later. Ruffcreek

Great..Congratulations!!!

Congratulations!!

cg, Great to hear of your fantastic news!! Ruffcreek

Way to go!!!!

Berta and John, Thanks for your responses. I did contact a SS disability attorney in March 2008. He ordered my file from the PTSD clinic and based on that he declined to take my case for the following reasons: 1) My VA shrink had given me a GAF of 70. He said while other things go into this, the VA weighs the GAF heavily. 2) My psyc had written that my job had ended and I chose not to transfer with the company. Actually this was incorrect. I did not have a choice to transfer but I had quit due to PTSD symptoms. So I decided to wait until the VA C & P was done. I will now apply for SS disability without the attorney. Ruffcreek

I'm hoping someone can give their opinion as to what my chances are of getting an increase in PTSD and IU from the information from my C & P exam which was done on May 21, 2008. [My GAF was 55 and I was given 50% for PTSD in September 2006.] TESTS DEGREE OF SEVERITY OF PTSD SYMPTOMS BASED ON PSYCHOMETRIC DATA: Severe AXIS I: PTSD, chronic. AXIS II: No personality disorder diagnosed during this interview. AXIS III: SC for DM II, malaria, impaired hearing, tinnitus. AXIS IV: Moderate. AXIS V: GLOBAL ASSESSMENT OF FUNCTIONING. Score: 50 Comments: He reports severe level of symptoms in almost all of the 17th specific symptoms for the diagnosis of posttraumatic stress disorder. PSYC SUMMARY CHANGES IN FUNCTIONAL STATUS AND QUALITY OF LIFE SINCE LAST EXAM: Performance in employment, routine responsibilities of self-care, family role functioning, physical helath, social/interpersonal relationships, recreation/leisure pursuits. STATE PROGNOSIS FOR IMPROVEMENT OF PSYCHIATRIC CONDITION AND IMPAIRMENTS IN FUNCTIONAL STATUS: His condition has incrreased in severity from the time of the previous compensation and pension image two years ago. He initiated treatment in February of 2008. PTSD REVIEW: EFFECTS OF PTSD ON OCCUPATIONAL AND SOCIAL FUNCTIONING IS THERE TOTAL OCCUPATIONAL AND SOCIAL IMPAIRMENT DUE TO PTSD SIGNS AND SYMPTOMS? Yes EXAMPLES AND PERTINENT SYMPTOMS, INCLUDING THOSE ALREADY REPORTED: He has severe symptoms and is participating actively in treatment at the VA PTSD clinic. He is still early in treatment so is not possible at this time to make a realistic assessment in our treatment might diminish the present high level of PTSD symptoms. His present level of symptom reporting would keep him from being able to function effectively in gainful employment. I have been unemployed since Jan 2008. What additional information should I provide? I have heard that I will need a letter from my DR stating I cannot work. I am not sure that she would provide one. I am unsure of what further action I can take to help my case. If anyone has an opinion of the above or what I can further do I would appreciate the help. Thanks, Ruffcreek

JoAnn, Congratulations! I think there are two lessons to be learned by your story. 1: Ultimately we have to become familiar with getting our records and becoming familiar with the laws and them doing a lot of the work on the claims ourselves as you did. At the same time use the knowledge of the many experts on Hadit and others. 2: As Pete mentioned never give up. Ruffcreek

REPORT: VA NOW ACCEPTING CLAIMS FOR HYPERTENSION LINKED TO AGENT ORANGE EXPOSURE -- Will determine service-connected status at a later date, but claims are expected to be approved. VA begins taking claims related to Agent Orange exposure By Chris Roberts El Paso Times Veterans Affairs has started taking claims for hypertension related to Agent Orange exposure, but it will determine at a later date whether the claims will be honored as being military "service-related," according to service organizations who received notices from VA. A letter from the Texas Veterans Commission to its county service officers indicates that the claims are expected to be approved. The claims won't be actively "worked" until the VA makes its decision. Requests for comment made to local VA agencies were referred to Washington, D.C. However, after two days, the public affairs office in Washington, D.C., still had no comment. If the claims are approved, it could mean as much as $300 a month for Bob Snow, a retired soldier who worked as a forward observer directing artillery fire in the Vietnamese jungles. Snow - who worked with special forces soldiers and Montagnards, a French name for the indigenous people of Vietnam's central highlands - operated in areas sprayed with Agent Orange, a defoliant that knocked down vegetation used as cover by the enemy. Snow retired in 1982 and was diagnosed with hypertension by the VA in 1983. However, the condition was not considered service related and therefore his disability compensation was limited. If hypertension is connected to Agent Orange claims, it could mean as much as an extra $300 per month for Snow, which he said will relieve some of the pressure of the rising cost of living. Jeri Elena Mark worked as a radar mechanic for Hawk missile systems at a base in Vietnam where she watched planes drop Agent Orange on vegetation surrounding the camp, which was being shelled. She had experienced high blood pressure, a symptom of hypertension, during her Army career, usually associated with flashbacks from her Vietnam service. She retired in 1985, but her exposure is not considered combat-related, so she would get no increase in disability payments. However, her family would receive benefits after her death if the cause is related to hypertension copied from www.vawatchdog org 5-9-2008

Thanks for the advise from everyone. I called the VA 800 # yesterday regarding my May 10 hearing appointment and only got a recording of the date of my appointment. This morning I mentioned the hearing C & P to my VSO. He didn't know either why I was scheduled for a C & P. Then in this mornings mail I received a letter from the VA scheduling me for 2 C & P appointments. So I called the number listed and talked to a human. Since I had submitted claims I was pretty sure what they were for and I was right. On May 21 I have one for an increase in PTSD. On May 13 I have one for TDIU. I asked the lady what my appointment on May 10th was for and it is for bilateral hearing. I then asked why I was getting scheduled for the hearing C & P since I had not submitted a claim. She checked and said since I have submitted a claim for the TDIU, they check everything I am rated for. Makes perfectly good sense. If I would have mentioned this in my first post I'm sure somebody would have caught it. Anyway I was going nuts trying to figure it out. Thanks again. Ruffcreek

Berta, Just to let you know I did receive it. Last week I think. Ruffcreek

Background: 2 years ago I submitted a claim for tinitus and hearing. Result: 10% tinitus 0% on the hearing. The first part of April of 2008 I had appointment with my DR. and I indicated I had some pressure by my right ear. He sent me to a hearing DR and since ithe pressure was so slight he just recommended taking Advil. He also had his audiologist give me a hearing test. She said I had some hearing loss and would need a hearing aid. After I got home I thought maybe I should file for an increase on the hearing. I got a copy of my audiogram and found someone who is an expert on hearing loss and sent him a copy of my audiogram. He found that it would still equate to 0%. So I dropped the idea of filing for an increase and didn't talk to anyone else about it. This morning much to my surprise I get a call from the VA saying they need to schedule a C & P for my request for a hearing increase. I said I had not filed a claim and she said maybe a VSO had filed it. So I have a C & P scheduled for Saturday. I will be seeing my VSO tomorrow and will ask him but in the meantime, can a VSO or someone else file a claim for me without me knowing? I think what may have happened is that I filed for an increase for my PTSD in February 2008 and received a letter from the VA yesterday saying they would be calling to schedule a C & P. Does anyone think maybe they got their wires crossed on this C & P? If so what should I do? I was thinking about going to the VA for a hearing test anyway and get a hearing aid. Ruffcreek

I was diagnosed with PTSD 1 1/2 years ago and was given a 50% rating. GAF was 55. I was told that it wasn't required to attend treatments at the VA by a veteran's advocate shortly after. However about 2 months ago I felt my PTSD was worsening so I made an appointment with the VA shrink. From the progress notes of that meeting she indicates that I "seem to have endured severe traumatic experience, which he has carried for an extended period of time, and he does appear to be suffering from significant symptoms related to his PTSD symptoms." She gave me a GAF of 65-70! The following meeting she gave me a GAF of 70. Also I am now on a couple of medications and at our meetings she tells me how much better I am getting!! This is good however I feel things haven't changed as she says. The thing I am now worried about is that I have submitted a claim for an increase on PTSD. With the information she is putting in her progress notes, when I do have the C & P for the PTSD increase I may end up getting a decrease! I'm not sure that I made the right decision. This definitely makes the PTSD worse! Jack03 if you decide to go for treatments I would recommend finding a MH care provider in your town and keep all your records for documentation. Ruffcreek

WOW...Sounds kind of scary to me. I have been sleeping very irregular hours with the nightmares and such as many others with PTSD can testify to also. I have just gotten used to my CPAP to where it dosen't interupt my sleep. Only the nightmares, etc. Guess this should knock me out but the side effects kind of worry me. I'm going to have to do more research and talk to my non-VA Dr at my appointment on Friday. Thanks for your comment 999. Ruffcreek

I was just taken off of Trazodone because it wasn't having any effect. Received a supply of Zolpidem Tartrate (Ambein) today. Anyone tried it? Ruffcreek

TS Way to go!! Congratulations!!! Ruffcreek

Terry, Hope I don't drag this out too long. I submitted a claim for hypertension as secondary to the SC disability of diabetes mellitus, type 2 with dietary restrictions and it was denied on 1/8/07. With the original claim my DR. sent in his statement "as likely as not" caused in part and/or aggravated by the diabetes. He also states that I was diagnosed with and began treatment for hypertension approximately one year after being diagnosed with diabetes. In their decision I was denied because of (1) Blood pressure was elevated prior to diagnosis of diabetes, and (2) my most currernt renal function studies at the VA dated July 2006 were all normal. Therefore, this would show that your diabetes has not interfered with any renal function, making it unlikely that your diabetes is causing your hypertension. On August 31, 2007 I appealed. Also sent another letter from my DR stating "as likely as not". He also points out again that I was diagnosed with diabetes in 1999 and hypertension a year later. Later in looking through my med records I found that my renal function scores were in Stage 2 and 3. My DR wrote another letter stating my GFR is mildly reduced and that it is likely due to both his hypertension and diabetes. On 2/28/08 I was called in for another C&P. Took my med records showing the renal function scores and presented to the examiner. In her notes of the C & P final reports she writes that I have asymptomatic mild chronic kidney disease, and it is at least as likely as not due to diabetes mellitus type 2. If I get a 0% I call it a victory. Just have to wait it out. Ruffcreek

Viet Nam Tanker, My wife is Type II, and tried the cinnamon tablets a couple of years ago but they didn't seem to have any effect on her readings so she discontinued taking them. Don't know for sure if they were 500 mg or not. I have heard that they work for some people so I guess it wouldn't hurt to try them for 3 or 4 months. I think if you go to drweil.com he has some info on them as well as quite a few other sites. I am type II with my reading going up around 170 in the last couple of months. Just today a began taking 500 mg of metforfin twice a day up from 500 mg once per day. Hope to stay away from the insulin as long as possible. Hope you find something that helps. Sounds as if you will probably need to increase the insulin. Good luck, Ruffcreek