ptsd A Little Warning For All -

[Philip Rogers]

One of my vets called me yesterday. In 1995 he was awarded 100% P&T, for PTSD, retro to '91. Last year called in for Comp exam. Examiner reported vet has improved. Vet fails to rebut report. Recent Comp exam reports still improved. Monday vet receives notice of intent to reduce to 50% compensation level. The VA has followed the 10 yr protection rule, in that it takes 2 exams reporting improvement to reduce a 100% vet. Now vet is in a panic. Watch for more of this as the VA tries to tighten budget. This is from the Spokane, WA, VARO. jmo

pr

Edited June 20, 2007 by Philip Rogers

[vaf]

A veteran who is 100% schedular cannot file for TDIU unless he/she has been reduced to a lesser rating, regardless of whether the rating is P & T or not. At least that's what the VARO told us here when we asked this exact same question.

Is this not correct?

Schedular means you've been rated 100% per all your separate disabilities combined, as calculated in the combined ratings table in 38 CFR, rather than the VA deeming you unemployable (Totally Disabled Individually Unemployable = TDIU).

100% schedular doesn't prevent the veteran from working, whereas for the most part, TDIU surely does.

[calnight]

SO DOES P&T REALLY MEAN NO FURTHER EXAMS. I HAVE POSTED MANY TIMES THAT JUST BECUASE YOU ARE P&T DOES NOT MEAN THE VA WILL CALL YOU BACK FOR ANOTHER EXAM IF THEY FEEL YOU ARE IMPROVING. i STRONGLY SUGGEST YOU SEE YOUR DOCTOR AT LEAST 1 EVERY 3MONTHS. ME AND MY VA SHRINK HAVE A GOOD REALATIONSHIP. HE HAS TOLD ME IF THE VA COMES AFTER ME TO REDUCE TO CONTACT HIM AND HE WILL TAKE CARE OF IT. i KNOW SOME WILL STATE REGS AND LAWS BUT FACE IT THE VA DOES NOT FOLLOW THERE OWN LAWS. YOU MUST BE PROACTIVE IN YOUR TREATMENT EVEN IF YOU FEEL THE TREATMENT DOES NOTHING TO HELP. EVERY TIME I HAVE A APPT WITH MY SHRINK I MAKE SURE TO GET A COPY OF THE REPORT. JUST BECUASE YOU HAVE WON YOUR CLAIM DOES NOT MEAN IT IS TIME TO RELAX AND THINK THE VA IS GOING TO FORGET ABOUT YOU. THE BATTLE WILL NEVER END AND YOU MUST BE PREPARED TO FIGHT AGIAN THIS TIME TO KEEP WHAT YOU HAVE EARNED. WITH THE IRAQ WAR AND THE HUGE NUMBER OF CLAIMS BEING PROCESSED THE VA IS GOING TO LOOK TO CUT BACK. AND PTSD IN MY OPION WILL BE THE FIRST THING LOOKED AT. AND WIN THAT DAY COMES WILL YOU BE READY. WILL YOU HAVE CURRENT DOCTOR REPORTS. OR THE LAST TIME YOU SAW A DOCTOR HAVE BEEN YEARS. SOME WILL DISAGREE WITH ME BUT FACE IT IT WILL HAPPEN. BUT I HOPE I AM WRONG. I WANT EVERYONE TO KEEP WHAT THEY EARNED AND BE PREPARED FOR THE WORSE. i AM 34 AND KNOW SOME DAY IT WILL HAPPEN TO ME BEING YOUNG AND HAVING 70% AND I.U. WITH SSD. BUT I READY FOR THOSE ASSHOLES. ARE YOU?

[Philip Rogers]

He has 30 days to request a hearing regarding the intent and it cannot be reduced until after the hearing. He hasn't worked in 16 yrs and therefore that will be part of the argument. I feel it best to attack the scheduling of the comp exams as it violated VA policy, in that his condition hadn't improved in over 5 yrs and he's over 55yo. There is no doubt in my mind he'll win, I'm just trying to stop the interruption in income level, in the mean time.

pr

[Jay Johnson]

The Seattle RO pulled the same stuff with the wife. They tried to drop her from 100% P&T (found just 8 months prior to moving to this region by Philly RO) to 50%, then to 70% with TDIU and, eventually, back to 100% with P&T again, but it took phone calls to the acting director and a personal phone call from the review officer to the wife to get it done.

The way I read the VA regs is that the VA cannot subject a P&T vet to a comp exam unless they have new and material evidence to warrant it. However, a veteran also doesn't have the right to refuse a C&P exam, so it becomes a catch 22.....if you don't go they can immediately drop you to 0%, but in order not to go legally, you need legal intervention which isn't afforded to vets. On top of that, once you've gone to the exam the VA now has "new and material evidence" so they can do whatever they want at that point.

I really think this person's case needs to have some money and effort thrown behind it and it needs some public attention. P&T means P&T, not "likely P&T, but we'll check later". Either the VA needs to be less liberal with handing out P&T or they need to do away with it all together, but they can't award it and then ignore the award.

Also, a 100% rating means "total occupational impairment", so the VA should not be able to lower him without awarding TDIU unless there is clear evidence of employment or that the VA has strong evidence that the veteran is being fraudulent and not working on purpose (a really hard claim to prove mind you).

Unfortunately, this seems to be status quo for the Seattle RO, but despite their fishing expeditions they still need to follow the regs in the end.

By the way, I can probably dig up some contact info I used in my wife's case (if I can find it all), so PM me if you want it.

[Jay Johnson]

By the way, the VA's regs state that a 100% vets needs to have "material" improvement without the need of aid. In other words, if the vet has "gotten better", but said improvement is due to ongoing meds and not working then that is not basis for reduction. In order to lower him they would need to show that he is not on meds and that he is "choosing" not to work, which seems like a long shot to me. Get senators involved and everyone else you can...hell, call the local press and get the media on your side.

One more note, what prompted the C&P? Had he asked for an increase? Does he have another disability? Is he routinely seeing a VA psych and that psych noted improvement in a regular appointment? If the VA did this without ANY cause I think this needs to be fought HARD.

[Berta]

"SO DOES P&T REALLY MEAN NO FURTHER EXAMS. I HAVE POSTED MANY TIMES THAT JUST BECUASE YOU ARE P&T DOES NOT MEAN THE VA WILL CALL YOU BACK FOR ANOTHER EXAM IF THEY FEEL YOU ARE IMPROVING"

As Calnight said this is SO true-

one of my friends was in quite a state because he got a letter for a C & P- he had been 100% P & T with SMC for 11 years. I know the dates exactly as I got him this award.But then his SMC was dropped due to improvement in his cancer-(I think that decision was erroneaous but he didnt want to fight it-

WHat appeared to happen is that-after years of denying PTSD he went to my new rep and the rep got him 50% PTSD.Added with something else SC in VA Math (maybe 40% for GSW)he then got SMC again-It seemed the VA was questioning that award -the PTSD award-to see if he had improved.

I told him to write back to the RO and ask them how a disability(PTSD) due to a severe gun shot wound could possibly improve.A GSW is an obvious lifelong stressor,and his GSW is clearly corroborated from the annuals of Blackhorse and his med records from Hoi An- not only that this vet had TWO GSWs on his DD 214-forget how they say 2 Purple Hearts on the DD 214-I saw his Purple Hearts many times-

it made no sense what they were doing.

In about 3 weeks the VA concured with the vet- no further exams at all.For anything.