ptsd Ptsd Claim Deferred And Also Iu

[NamVetWife]

OK I have posted this elsewhere but I am trying to get it straight what DH and I should do. June 2008 DH filed claim for increase on SC peptic ulcer disease plus etxras, also filed claim on PTSD (his Dr told him to do this) and also one on his lower back (he has documented back injury from Nam).

SC got increased to 60% which is wonderful. Back was denied as they said no connection between Nam injury and what is going on now (other Dr's disagree) the PTSD which had been diagnosed as severe repressed PTSD, put in program, on meds, monthly appointments - was deferred for more information. His GAF is 45. How much more do they want? The head of the PTSD Clinic is the one who diagnosed this, then this was seconded by the head shrink. Do they not believe their own doctors!

Then next in the awards letter came IU deferred - we had not submitted a claim for IU as we thought you had to have at least 70% to start with and prior to this DH was at 30%.

DH is really mad, he wants to go straight to congressman, I said from what I had read on here we needed to submit a NOD as the evidence from the 2 Dr's and his inclusion in the PTSD clinic and meds should have been a no brainer - but then we are dealing with the VA.

I did not mention this previously (in other posts) but DH took a really bad fall hit his head and has not been good at remembering things , C&P for PTSD referred to this - my thinking is that gave the window of opportunity to the VA and that is why they deferred. It doesn't change the fact that he has PTSD or that he is on the meds - he has it and it isn't going away by itself.

Another strange thing - we have used the local VSO to submit claims etc (personally I am unimpressed he hasn't seemed very helpful as far as I am concerned). In the awards letter it states that a copy has been sent to the Veterans of Foreigh Wars - have no idea why that was done we have never enlisted their help or even know anyone who is connected with them.

Any help would be appreciated.

[purple]

Something really stood out in what you wrote when you said that your hubby was "put in the program" about PTSD. What program? Is this a PTSD treatment program??? If so, I have heard from folks working inside that VA that that will get you a denial for a PTSD claim almost every time.

Why? Because you (or your hubby) are in "active treatment" and likely to improve coming out of the treatment program. I was told this by a psych doc in charge of one of the PTSD treatment (residential-type) programs!! So therefore, the VA denies and waits....i.e. defers.

One GAF score really doesn't mean anything for a claim.

[NamVetWife]

Grunt daddy - the SC was upped to 60% if I have read info from this site correctly DH could apply for IU with this. He had already been thinking of trying for the IU but thought he had to have at least 70%.

Purple DH is in the PTSD program at the VA hospital nearest to us, he is on several meds. The Dr has told us this wont "cure him" but will certainly help him to be able to deal with the PTSD. If I remember correctly he will be on theses meds from here on out.

[Pete53]

When you are not rated for consideration for TDIU the VA is required to look at and find a way to change your rating if necessary. They even have something called extra schedular. However in your case although 60% is never given for PTSD if he has a single rating of 60% and can't work he is eligible.

Apply for TDIU and what about Social Security?

[purple]

Yup, there is no "cure" for PTSD. Just my thought....from what I've heard....the VA will re-look at his PTSD claim once he is done with this program, probably do another exam and see how he is then.

[Berta]

The VA will not adjudicate a TDIU claim until they get the filled out TDIU form.

70% generates the VA to send the form but any vet can send it regardless of %.

My husband had 30% SC PTSD. He applied for higher rating as well as TDIU.

6 years later they awarded 100% SC PTSD.

He died after filing the TDIU form so I had to start from day one to re-open his 2 claims that were pending at his death.

It is medical evidence-that shows unemployablity due to service -that awards TDIU.

The 21-8940 form must be filed and then supported with medical evidence.

Medical evidence I used for my husband's award included:

2 VA hospitalizations for PTSD

SSA award solely for PTSD

Results of all psychiatric testing (6 tests -results of which for some reason was not in his medical file and I had to get this from his shrink and send it to them)

Medical statement from his VA shrink that he was unemployable due to PTSD.

EEOC case testimony,

Vocational Rehabilitation records,

Corning College accomodation requests,

Medication records, and Vet Center records.

The VA gave the most weight to his VA psychiatrist's testing results and statement of unemployability.

Edited July 6, 2009 by Berta

[NamVetWife]

Berta, thank you so much for your input. Since DH has SC 60% for one medical problem I think we should go ahead and file for the IU - all they can do his deny it - whats new! Our family doctor has treated him for over 20 years, I am sure he could atest to the severity of the SC problem whcih makes it impossible for DH to work. If it had not been for health insurance thru where I work I don't know where we would have been all these years. Would the two c&p's that were done for the ulcer condition be enough medical evidence or a statement from our doctor stating progressively worse condition with no cure available. I am not sure exactly what would be needed - both Dr's who did the c&p's stated due to the severity of the condition plus the irreversible surgery done while in service there is no cure, only take meds to relieve the condition.

I am hoping the PTSD will be rated - I really don't understand why it was deferred - if PTSD is always going to be with us and the meds a life long thing - it seems pointless to me to not give a rating. I know the VA marches to a different drummer and what is usual for the rest of us is definitely not the same for them.

Thank you all for the information - at least here on this site there are people who know what it is like to try and make progress with the VA - it is frustrating at best.