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Claim Status-almost There?

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crosssabers

Question

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.

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  • HadIt.com Elder

If you don't hear back soon I would consider asking for a Hearing. The lack of C&P's means that you are still stuck in development and an initial claim should be wrapping up before now.At least he had one C&P.

Good Luck

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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?

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Here is our response that just came in:

trnsp.gif 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

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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...

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