crosssabers

UPDATE- Received initial rating, was granted 10% PTSD until it is re-evaluated after a C&P. Back problems were deferred until a C&P for that too. Hearing loss and tinnitus were denied. I still cant understand why they rated at all since i'm only rated at a total of 10% now until they get more info. Wouldn't it have saved everyone the hassle if they just did a C&P a long time ago? Oh well, better to keep on waiting than to be decided without current info. I'm hoping for the best. By the way-I had been asking for exams since May but was told that they had enough to make a decision. We'll se where this goes soon enough....

I wondered about the CUE since at least some of the documentation (the most important to the claim) is from VA with a cut and dry diagnosis (AXIS & GAF).

Need advice: Does anyone think it would be beneficial to write back to amend the inquiry to ask if they have all documentation needed for the decision? Or is it plainly stated that they have all they need if it is in front of the rating board at this point? Just don't want to get denied beacuse they didn't request C&P's for the two biggest parts of the claim...

Hate to ask...I looked up SOC (didn't know what it meant, doing the best I can with all the new acronyms!) B) So now I know it means Statement of Case. How can the inquiries be used against me/my claim?

Hopefully it will be decided favorably without C&P's. You'd think the VA/Army documents would be enough. It's not like a LOT of time has passed and there is a claim without anything to back it up... Just got this back from IRIS-seems pretty hopeful: Response (Department of Veterans Affairs)06/25/2008 10:46 AM Mr. XXXXXX: Your claim is still pending. The file is out the the rating board. What they decided is still unknow. Once we receive the file back in we will enter the decision and sent out a letter. We hope to resolve this within the next 6 weeks. Thank you for contacting us. If you have questions or need additional help with the information in our reply, please respond to this message or see our other contact information below. Sincerely yours, XXXXX Veterans Service Center Manager

Here is our response that just came in: Discussion Thread Response (Department of Veterans Affairs)06/25/2008 10:46 AM Mr. XXXXXX: Your claim is still pending. The file is out to the rating board. What they decided is still unknown. Once we receive the file back in we will enter the decision and sent out a letter. We hope to resolve this within the next 6 weeks. Thank you for contacting us. If you have questions or need additional help with the information in our reply, please respond to this message or see our other contact information below. Sincerely yours, XXXXXX Veterans Service Center Manager

We just don't get why the Patient Advocate (great guy-very helpful to us over the last year or so for other issues as well concerning the VA health care system) would tell us that the rater said the claim should be finished in two weeks. Also, the 1-800 # has said over and over that it is awaiting decision. We understand that they have limited info-but aren't development and decision two completely different things? He provided more medical info to them at the start of the claim than it seems C&P exams involve. One one document alone it is written in similar format of a C&P, after a 3 hour conversation. VERY informative, with AXIS and GAF. Couldn't they decide on a rating using something like that?

His VSO said that the POA (American Legion) hand delivered it to the proper dept since they are in the same building. SO, hopefully they have it now. Again. We'll see. B) The last time he talked to them via the 1-800# they verified that they did indeed have it and that it was again awaiting decision...hopefully this is almost over. We're back and forth about thinking they'll request a C&P at this point. But wouldn't they have already done that if they were going to? In his stressor letter he listed and described three things off the top of his head... 1. Seeing someone on his squad die a horrific death, 2. Constant mortars (he was there for the Invasion), & 3. A mission gone bad. Hopefully that'll do it. We used the IRIS system yesterday afternoon to inquire directly to the appropriate location as to the status of his claim, so I'll post again as soon as we get a reply.

Thanks Rentalguy-I was asking about claims being decided, not denied, but this brings up a question about that. If VA is provided with hard evidence in support of a claim and they do not request a C&P, just deny outright-wouldn't that count as a CUE? They were provided a couple years worth of documentation including a 5 page document from VA Mental Health including a diagnosis (AXIS) and GAF dated 6 months prior to filing for the claim. I feel that would be a terrible injustice and wonder if they can just get away with overlooking something like that?

I'm sorry-I think I wasn't as clear as I should have been in my last reply...oops! The Patient Advocate said that from what he saw he's not surprised that a C&P wasn't needed, since my husband already had a document nearly the same as a C&P exam (but actually a little more informative) was in the system since it was written by a VA doc. Also, he had gone for a few visits and tests for his back issues shortly before filing the claim. So all that was in there. We understood the C&P in March for the hearing and tinnitus since he didn't have much for proof on those ones. At that time we asked if there were any more exams scheduled and VA told us no. On June 9th when my husband talked to the Patient Advocate again, he called the RO in L.A. then called back to tell him that it would be about 2 weeks for the rating to be done. Now, as of yesterday his VSO/POA has informed us that the stressor letter is not in his file...so we're wondering if that is just a T to cross before awarding the rating, or if it is the beginning of a whole new ball of wax?

Thank you Berta for your response. Yes, we have researched everything as thoroughly as possible, though I thank you for taking the time to include the links. He did put quite detailed info in the stressor letter. He received an Air Medal and was involved in some pretty horrifying ordeals which should be easy enough to verify. The letter was provided to them in February, and we did not hear anything else about it until this month, and that was just to say that they did not have it in the file. We are confused as to why the issue of them not having the stressor letter is coming up now, when everything else has been completed to our knowledge. The patient advocate we use talked directly to the rater two weeks ago and he told us that it would be completed very soon (2 weeks) and that no C&P is a good thing, he even went as far as to say from what he saw my husband should be rated at 50-70% for PTSD. (He looked over the file and said it was enough to rate on since most of his care has been through the VA.) Is it usual for them to up and change direction at this point in the claim process?

My husband filed a claim in August of 2007 for PTSD, L-5 S-1 Back issues, as well as hearing loss and tinnitus. We are already aware of the probability of receiving 0% for hearing and 10% for tinnitus. We submitted a stack of paperwork in support of his claim. Most of the medical evidence was either from his time in Active Duty Army (Attack Helicopter Pilot) or within the year and a half after discharge. He has had quite a few incidents causing him to seek help in the years after returning from Iraq. One key piece of evidence being a 5 page document from VA Mental Health including an AXIS stating PTSD, Adjustment disorder w/ mixed anxiety and depressed mood for Axis 1, Herniated Discs L-5 S-1 for Axis 3, and Severe: occupational difficulty aculturating back to society for Axis 4, and GAF of 50 all dated Feb. 2007. He was scheduled for an audiology C&P exam in March 2008. Went to that and didn't hear anything further. No C&P's for the PTSD or back. Our VSO is not sure what will happen since she has never had a claim the exact same as this. We contacted the patient advocate from our nearest VA hospital and he directly contacted the rater 2 weeks ago today, then he gave us the news that the claim should be finished in about two weeks from then. Well, here it is, not that we expected everything to be final, as we do understand that these things take time. We have called the VA 1-800 # about once per week over the last month, and keep hearing some strange things. The 1st time we heard it left the rater once it was pending decision is because they needed a form that they didn't have in the file. Got that resolved with the file back in line on May 13th. The 2nd time they needed more info from the C&P. OK, done. They got that back on May 29th. Now it has left and been returned twice in June due to not having the stressor letter. That was sent to them back in Feb. of this year, but to be on the safe side his POA is making sure they get it yet again today. Now, our question is this...does it seem like we're at the end of the line here? We just don't know what to expect and time is of the essence since my husband is having a really hard time at his job, he works on a military base and he is holding it together by a thread. The thought of this claim being finished and the possibility of applying for IU so he can devote some time to seeking help while keeping food on the table and diapers on our 9 month old is keeping him together. We are waiting with baited breath to see if he will be eligible in the first place. We know that he should be rated at 70% for PTSD alone, back is questionable as to how they will rate it. He becomes incapacitated at least a few weeks per year. Any thoughts or advice would be very much appreciated. Thank you.

Hello there. I am wondering if anyone has had their claim decided without a C&P? I submitted plenty of paperwork in support of my claim, most from VA itself, so I am wondering if this has happened to anyone else out there?