ptsd Ptsd

[wapiti]

In 2006 I was given an initial rating of 30% for PTSD. I asked for a rate increase and had my C&P exam on 8/15/07. The doctor gave me a GAF of 35. He stated that I was totally impaired in occupational adjustment and capacity, as well as being impaired in most areas of social functioning. His current level of adjustment requires continuing psychotropic medication. The VA sent their reply on Nov. 7, 07. They denied my claim for a rate increase keeping my rate at 30%. Their reply was as if they did not read or look at my C&P exam. I talked to a VVA VSO and he told me to go to a private doctor for the PTSD exam, and then file a NOD. Does anyone have any suggestions on how to proceed next ? Thanks for any suggestions

[wapiti]

I would ask for a DRO Review and ask them to read the C&P that was given by their Doctor. If you are unable to work which your C&P says you should be 100%. An outside opinion may help but I think you should win based on the VA opinion. You should also ask for a full statement of the case to refute the VA decision.

Good Luck

What is a DRO review?

Do I write a letter asking for a review?

I am not sure what you mean by asking for a full statement of the case to refute the VA decision.

I'm sorry guys, I'm lost with this stuff.

[Pete53]

DRO is a Decision Review Officer who is supposed to give a fresh look at you claim that was turned down. It usually takes a couple of months and than if it does not go your way up to the BVA. In other words another shot at the apple.

I really believe that many Veterans make a mistake by not asking for hearings when the VA turns them down or low balls their claim.

[Berta]

Wapiti-has the VA sent you a DRO request form yet?

Also did you get a VCAA letter and an election response form under the VCAA when you first filed this claim?

"Do you just write a letter and ask for reconsideration?

Attach the C&P exam?

Mention my years of unemployment?

My drugs and their side effects?

Should my wife write a letter?"

I say yes to all of above and tell them how the SOC clearly disregraded the C & P results and the GAF etc.

"What else should I send?"( I would send then the filled out TDIU form too and ask that it be considered.

If I were you I would cite right in the request for reconsideration the following regs -I copied this from my last response to the VA and they have been actively moving on my claim ever since getting it:

"I will list the evidence I am again enclosing , to include the signed Election Notice,

And I cite the following established VA case laws and regulations and ask that they be properly applied to my claims:

§4.6 Evaluation of evidence.

The element of the weight to be accorded the character of the veteran’s service is but one factor entering into the considerations of the rating boards in arriving at determinations of the evaluation of disability. Every element in any way affecting the probative value to be assigned to the evidence in each individual claim must be thoroughly and conscientiously studied by each member of the rating board in the light of the established policies of the Department of Veterans Affairs to the end that decisions will be equitable and just as contemplated by the requirements of the law

“b. Review of Evidence. Concisely cite and evaluate all evidence that is relevant and necessary to the determination. Rating decisions must evaluate all the evidence, including oral testimony given under oath and certified statements submitted by claimants, and must clearly explain why that evidence is found to be persuasive or unpersuasive. Decisions must address all pertinent evidence and all of the claimant's contentions. “

Source: September 23, 2004 M21-1, Part VI

CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS

PART 3_ADJUDICATION--Table of Contents

Subpart A_Pension, Compensation, and Dependency and Indemnity

Compensation

Sec. 3.159 Department of Veterans Affairs assistance in developing

claims. (XC 24 884 978 Page 4 of 5)

(a) Definitions. For purposes of this section, the following

definitions apply:

(1) Competent medical evidence means evidence provided by a person

who is qualified through education, training, or experience to offer

medical diagnoses, statements, or opinions. Competent medical evidence

may also mean statements conveying sound medical principles found in

medical treatises. It would also include statements contained in

authoritative writings such as medical and scientific articles and

research reports or analyses.

(2) Competent lay evidence means any evidence not requiring that the

proponent have specialized education, training, or experience. Lay

evidence is competent if it is provided by a person who has knowledge of

facts or circumstances and conveys matters that can be observed and

described by a lay person."

Edited December 29, 2007 by Berta

[Berta]

"I am thinking about finding a new vet rep, the one I have is a nice person but when I asked for suggestions on what I should do, she said she could not make any suggestions and that she would fill out the paperwork when I figured out what I wanted to do."

Will she give you her salary?

It is her job (and whatever vet org she is with has a clear mission statement as to what her job is) to prosecute your claim fully and to 'suggest' any means at all that could help the claim succeed.

Where do these people come from?

How does this rep handle an elderly WWII vet who might be catastrophically disabled? Ask him to come up with something himself?

I wonder what is worse- those who right off the bat dont have a clue or those who play God and give reckless claims advise like it is the Holy Grail- and dont have a clue.

[Pete53]

Berta:

You know more than most of the SO's I have dealt with so I guess that in a way you are sort of intimidating to your SO. However the SO should be happy to work with you and be pushed to learn more to help other Veterans in my opinion.

[Berta]

Pete-funny thing- my local rep stated I knew more then them in an email to me when I corrected his advise-a real kiss a-- email --- but he might have been scared.

I felt he was just being patronizing-he had told me that evidence cannot no longer be submitted when a widow or vet asks for a DRO review.

We were here with a vet working on his claim and I waited until he got back to hos desk to email him the regs that showed how wrong he was-

how many vets or widows did he tell that crap too?

I was willingly doing volunteer work for them and had had an excellent relationship with his boss for almost 20 years- a man I respected to know VA case law-and his boss too made sure my claim got messed up-

I almost think they wanted to damage my credibility in the vets community round here-if I cant succeed on my claim how can I help others?

The director and 3 reps made me feel I had been gang banged and could not do a thing about it-

they were wrong and will never deliberately screw up another claim when I get through with them.

Or they were simply incompetent-and hoped I would not question their advise.

I used that email to support my complaint as well as 2 letters from the director and other emails that shows they dont know what they are doing.

Theye didnt discriminate- I know of others they messed up too.