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WHOLESALE
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Posts posted by WHOLESALE
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Wow Shark, nice to know there are VA docs out there willing to go the extra mile for vets. That's a great letter that gets right to the point.
Kudos to your doc, frank
I have attached a letter that I got my VA Psychologist to write to include with my NOD for denial of TDIU. I am rated 80% overall 50% for PTSD and the rest AO related. I have blacked out all identifying info, but it may be a good example to provide your doc to get him to write something on your behalf! -
Oh, and a great IMO definetely helps. Some doctors do not know how the VA works and it is up to the Vet to make sure includes the right verbage..
Some examples would be:
"I have reviewed the veterans full claims file and medical records."
"In my professional opinion the "event" that is documented and occured during active duty is more likely than not related to the veterans current disability."
There are others,
frank
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Submitting it in person is BEST way since you get it date stamped. Sending it certified mail only means they recieved the envelope, not the contents within. In other words, it they lose it you still have no proof they received the contents...no date stamp, nothing
frank
never trust va. send everything certifiied mails return receipts and itt woulds not hrut to have it notoriezed.even then they can lose it osya they lose it.
we need big protest of all va's on same day aronund the country to get atteentinon brought to this. milllions of disbaled vets and thhe service orgs get nooting done in theeir mettings and letters. vets need to band togtehrt for protestts.
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Pete, I thought about this question and I don't think there is a BEST way per se for service connection. Since every VARO can differentiate within the vague regs a best way at one VARO may be different at another. The only advice I would give is follow the standard rules of VA protocol.
Here are the three elements according to Hickson case.
(1) a current disability;
(2) in-service incurrence of
disease or injury; and
(3) medical nexus.
You get all these you have a strong case and likely will be granted in the end even if you have to appeal.
frank
Can we please stay on target? please give your opinion/idea of a best way or better way.Thanks
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yep yep, the VA has regulations they are supposed to follow but they interpret these regulations to their best interest, not the best interest of the Veteran. This mindset has been set in stone and will require change from the TOP before we see a different way of interpretation of the regs.
I can just see a rater going to the boss and saying "hey boss, I just found another way to get this claim denied." Boss then says, "Great job! Keep up the good work."
frank
Pete992,In my opinion the VBA denies claims such as these on a daily basis.
I think some of the reason for these denials is because VBA negates
following the rules and regs set up for the claims process.
I think many decision makers look first for a way to deny the claim,
thus putting the claimant into the NOD and appeals process basically
from the get-go.
It would be nice if VBA decision makers would work claims
as smoothly as laid out in your post.
I feel this does not happen as often as it should,
even when there is clear cut medical evidence in the claimant's SMR's.
jmho,
carlie
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B) ...had my mouth open but couldn't get the words out......
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I AGREE WITH PETE..... B)
Any award of 10% in my opinion is a lowball but a lowball that can open some new doors. -
BR, here are a few court cites....
The list of symptoms under the rating criteria are meant to be examples
of symptoms that would warrant the evaluation, but are not meant to be EXHAUSTIVE, and the rating board need not find all or even some of the symptoms to award a specific
evaluation. Mauerhan v. Principi, 16 vet app 436, 442-3
Ultimately, in this case the Courts upheld the Board's decision noting that the Board had considered all the Veteran's psychiatric symptoms, whether listed in the rating criteria or not, and had assigned a rating based on the level of occupational and social impairment. Mauerhan v. Principi, at 444.
Applying this analysis to your psych exam rating, it follows that you should be entitled to a higher rating if your condition causes a certain degree of occupational and social impairment, regardless of whether you had some, all, or none of the symptoms listed in the rating formula. In your case the examiner indicated you are deficient in most areas which is indicative of a much higher rating, 70% to be exact.
frank
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also, NO co-pays for any medications 50% and above and automatic Priority 1 for medical care.
frank
Jessie,Love good news!!!
Congratulations!!!
BoonDoc
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BR, I would immediately file an appeal tomorrow. Let them know you dissagree with the rating assigned and that you request a higher rating. According to the regs you were LOWBALLED bigtime. Just a fraction of what's in your SOC should at least qualify you for a higher rating than 10%.
Many vets don't appeal and the VA knows this so they just flat out LOWBALL. They know it's a 50/50 chance the Vet won't appeal.
frank
TS, there is not any sentence following".....such as forgetting names, directions, recent events." I will put down everything that's on the raing decision for MDD:2. Service connection for major depression disorder as secondary to the service-connected disabilities of early degenerative joint disease of the left knee and calcified left quadriceps muscle.
Service connection for major depression disorder has been established as related to the service-connected disabilities of early degenerative joint disease of the left knee and a calcified left quadriceps muscle. The facts listed in issues #1 and #3 are hereby incorporated by reference.
Your recent VA examination notes you report depressed mood, low motivation, insomnia, low energy, decreased ability to concentrate, excessive worry and anxiety, low self esteem, hopelessness, anhedonia, difficulty falling and staying asleep, and passive suicidal ideations. You report panic attacks once a week, associated with shortness of breath and rapid heart rate, precipitated by crossing over bridges , or being in elevators and planes. You report having few relationships due to your limited physical and mental capacity. You currently received outpatient psychiatric and psychological therapy, as well as take oral medication to help control your symptoms.
Interview reveals you are oriented to all spheres, with constricted affect and a depressed mood. You are unable to perform serial 7's or spell a word forward and backward. Your thought processes and content are unremarkable. Your remote memory is within normal limits, your recent memory is mildly impaired, and your immediate memory is moderately impaired. You deny any history of delusions, hallucinations or homicidal ideations. The examiner diagnosed you with single, moderate, major depressive disorder due to your service connected early degenerative joint disease of the left knee and calcified left quadrieps muscle. His rationale being, you had an excellent work record and academic record but have coped with chronic pain and further orthopedic distintegration and began to feel useless, and loss sense of your role in the world, unable to do much for pleasure or others, and developed a long standing depression beginning after a number of years of struggle. He assigned you a Global Assessment of Functioning score of 53, and noted that you are mentally capable of handling your own finances.
An evaluation of 10 percent is assigned from December 27, 2007. An evaluation of 10 percent is granted whenever there is occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress; or symptoms controlled by continuous medication.
A higher evaluation of 30 percent is not warranted unless there is occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although genrally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).
This is the whole thing that's on my rating decision for major depression disorder. I will try to contact the IMO/IME doc tomorrow for an opinion tomorrow. Thx
Chow!!!
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yep, very possible...Should apply now since you meet the percentages. Should have gotten an inferred claim for IU.
frank
i am currently rated 90% 50% depression 3o% lt hand 30% rt hand 20 % lt foot 20% rt foot 10% broken clavicle 10% tinnitus i entered the voc re-hab program and am having no luck at all in it. i have not had any income since march to speak of. i am becoming more and more mentaly house bound, as i am becoming too depressed to leave. i think i am on too many meds to be that reliable anyway. is tdiu an option at this point thanks and please pray for our troops -
babyray, an IMO takes time. I just hope you know that since it seems like your in a big rush for this.
They will need to review your medical records in order to do this.
frank
I am seeing a private psychiatrist & psychologist ( whom I am taking psychotherapy ) in which I had a GAF score of 45 but not 53, which 53 is a error on my part. Currently I am seeing a VAMC psychiatrist to get my meds thru the clinic, I dont' like him so I going back to my private docs.The statements from the private docs were extremely detail and should be in my c-file. Do you want my phone number so that we can talk one on one, which you can me collect if necessary. I am looking for a IMO doc today. Thx Chow!!!
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BR, I found a source in your area that might do an IMO or IME. If he can't he possibly can refer you to someone that does.
Here is his info:
General & Forensic Psychiatry
POGOS H. VOSKANIAN, M.D.
tel. 215 938 7227; fax. 215 938 7474; e-mail: forensics@pol.net
frank
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I guess it make a little difference to me since I asked the question. VA seems to want to go by objective instead of subjective evidence so I guess that's why I asked.
thanks for your input,
frank
Like life it can be either. A1C is a test that is objective. GAF is an opinion or evaluation made by a qualified person hopefully.What difference does this make anyway? You are subject to policies and rules and regulations of the VA.
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Yes, this would definetely be poisen to a "temporary" 100% rating I would think. Hence, temporary for the VA to take away at earliest convienence.
frank
I would bet that the reason you got a 100% non-permanent rating is because you are young. They are not supposed to do this but they do it all the time. The VA probably is hoping you will improve enough so they can reduce the 100% rating within a few years. Why not sign up for one class on your own dime to see if you can hack it. Stick your toe in the water before you jump in. Just be sure you don't tell anyone at the VA you are feeling better or taking a class. This would be poison to a 100% claim in my opinion. What exactly did you get the 100% rating for? Was it Adjusmtne Disorder? -
Is diagnosis part of exam subjective or objective?
I think it would be objective but just want to make sure.
thanks, Frank
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What is the reason you want him right there in same room with you for the exam?
frank
Here goes - uh, I have an mh exam coming up that could be soul baring (mdd/mst/PTSD) and my husband is going with me. Some or many things could be revealed that have stained and changed me. I am taking some notes to guide and remind me of events and issues.I am looking for advice about how to prepare and debrief him.
He is my soulmate, a pillar of strength and is aware of many things I've experienced. My concern is how he as a man may take exposure of graphic details that could come out by questioning.
Thank you kindly and prayers are appreciated,
Cg'up2009!
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have any of your doctors connected these in-service stressors to your current PTSD? Even when it's obvious, you can't expect the VA to assume this. On your SOC what was the full reason the VA denied your claim? I know you said they couldn't verify but were there other reasons?
I'm surprised the VA hasn't ordered you a Comp&Pen exam for "other opinion" for a nexus to your in-service events. You can always request a comp&pen exam through your VSO. Surprised your VSO hasn't requested this too.
frank
All data sent was for non-combat ptsd, and post concussion residuals. Am I missing something here? -
Babyray, below I posted the rating criteria for mental disorders (30-70%). Reason I say they didn't follow their own regulations is if you look at the rating criteria for 70% is clearly states, "Deficiencies in most areas." From looking at this part of your exam it is clear you're deficient in most areas such as work, etc. I'm not sure what exactly I would do but I think I would start by sending the VA an informal letter indicating you disagree with your 10% rating. And state in the letter that according to VA Schedular you feel you meet the criteria for a 70% rating since your exam is clear that you are deficient in most areas.
Take a look at the information below and compare it with your medical records and exam.
frank
Occupational and social impairment, with deficiencies in most areas,
such as work, school, family relations, judgment, thinking, or mood,
due to such symptoms as: suicidal ideation; obsessional rituals
which interfere with routine activities; speech intermittently illogical,
obscure, or irrelevant; near-continuous panic or depression affecting
the ability to function independently, appropriately and effectively;
impaired impulse control (such as unprovoked irritability with periods
of violence); spatial disorientation; neglect of personal appearance and
hygiene; difficulty in adapting to stressful circumstances (including
work or a worklike setting); inability to establish and maintain
effective relationships 70
Occupational and social impairment with reduced reliability and
productivity due to such symptoms as: flattened affect; circumstantial,
circumlocutory, or stereotyped speech; panic attacks more than once
a week; difficulty in understanding complex commands; impairment
of short- and long-term memory (e.g., retention of only highly learned
material, forgetting to complete tasks); impaired judgment; impaired
abstract thinking; disturbances of motivation and mood; difficulty in
establishing and maintaining effective work and social relationships 50
Occupational and social impairment with occasional decrease in work
efficiency and intermittent periods of inability to perform occupational
tasks (although generally functioning satisfactorily, with routine
behavior, self-care, and conversation normal), due to such symptoms
as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or
less often), chronic sleep impairment, mild memory loss (such as
forgetting names, directions, recent events) 30
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babyray, didn't mean to upset you in any way on my question. I was just trying to understand your situation better.
thank you for posting your section G to give us more light on your situation. That definetely looks like a 70% rating exam to me but lets see what others say.
Deficiencies in most areas = 70% and your report is clear on this. Looks like a CUE to me since they didn't follow the regulations on their own rating criteria.
frank
TS Snave,I appreciate your interest in my quest for fairness.
The tiger team isn't s_ _ t. The worst VARO in the country from what I understand.
I filed a recon claim for my MDD July 30, 2009.
This is what the C&P examiner wrote in section G:
Is there total occupational and social impairment due to mental disorder signs and symptoms? No
If there is not total occupational and social impairment, do mental disorder signs and symptoms result in deficiencies in the following areas (judgement, thinking, family relations, work, mood or school)? Yes
Judgment? No
Thinking? Yes
Examples including thosen already reported:
poor concentration, memory, attention
Family relations? Yes
Examples and pertinent symptoms, including those already reported:
irritible, grumpiness,
Work? Yes
Examples and pertinent symptoms, including those already reported:
pt tried a second career but pain and have not having the energy to continue he stopped last yr
Mood? Yes
Examples including those already reported:
low mood, low energy, lack of interest, feeling hopeless/worthless
Please get back with me right away. I like to know what you think about Section G. I think I should have gotten at least 30%. What do you think? Chow!!!
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WHAT IS YOUR OTHER CHRONIC HEALTH STRESSOR? This is probably why the va didn't increase your rating. If you have an issue that is not service connected the VA can use this against your claim, especially if their own psych opines this way. This is the way it looks to me from what you presented.
frank
The VA decision states that an eval of 10% is granted whenever there is occupational & social impairment due to mild or transient symptoms which decrease work efficiency & ability to perform occupational tasks only during periods of significant stress; or symptoms controlled by continuous medication.My private doc says I had MDD w/ a GAF score of 53; With my meds helping very little.
The VA's C&P doc says my therapy is helpful as are the meds . pt sees private pschiatictrist & psychologist, but even tho helpful depressive complex remains.
Also C&P doc says pt does not report remission even w/ some fairly effective treatment over the past 10 years & this failure to remit is most likely due to his chronic heath stressor & its aggravating effects upon his self image & mood.
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ME TOO....usually respond very next business day.
frnak
You can request that your IRIS inquiry answer is answered via phone.I know that the vet doesn't have a written record of the conversation, but one could figure a way around this.
I have been fortunate I guess, I have never had to wait over 48 hours for a response.
BoonDoc
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You can file ONLIDE at SSA.GOV You will also want to get your VA records to them and also your award letter for 100% VA. SSD doesn't have the same criteria as VA but 100% gives weight.
frank
I'm 100% TDIU for PTSD. Is social security disability awarded for PTSD?
Iris Request
in PTSD Post Traumatic Stress Disorder Claims
Posted · Edited by WHOLESALE
yep yep, Petes correct. You will probably get one of those "infamous" letters letting you know they are working as fast as they can on your claims and that your claims might be delayed due to the backload of claims."
This is what I got when I sent them a letter asking the status. I sometimes think it's best just to "FORGET" you even have claims with the VA. Makes for more pleasant fishing when the fish aren't biting.
frank