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Still Need Help And Input On My Claims

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68mustang

Question

Please need your advice on this. I received the dreaded envelope a couple of weeks. I was denied the claims for PTSD and for pulmonary fibrosis. I noticed that in the evidence used to deny both claims several pieces of evidence are not listed. Such as some copies of reports from my pulmonary specialist and a CT-scan performed by an imaging clinic, which I faxed to the VA and have confirmation they were received. Both pulmonary reports note that I have mild asbestosis. The PTSD denial has information missing that I discussed with the mental health examiner. I have requested a copy of the mental health exam to look over what the examiner wrote or excluded. I did not have a pulmonary exam because the VA never sent me for one even after I requested one.

I am in the process of obtaining letters from my primary doctor and pulmonary specialist attributing my mild asbestosis to asbestos exposure in my military jobs.

Since the Houston office has not provided copies of the mental health exam, can I file a NOD or what do you all advise I do? Thanks.

68mustang

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  • HadIt.com Elder

Get a copy that is complete of your C&P and you can also go to your Mental Clinic and request that they release copies so that you can use them in your claim.

You might consider asking a Patient Rep to help you get the records that you need. Right now all you have is a denial and nothing to dispute cause you don't know.

Knowledge is Power

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Pete is correct, as usual, and I would add that you should take the information from your C file and do a thorough job on your NOD. Cite specific examples. For example:

I disagree with the decision dated April 1, 2010 on the issues of Service Connection for PTSD and Pulmonary Fibrosis. I elect a DRO Review (or hearing, your choice). I believe the decision is incorrect for the following reasons:

1. On May, 1, 2009 I faxed a copy of a medical report from Dr. Smith to the Regional Office and have enclosed the fax recipt. This evidence was not listed in the "evidence" section, so the document was either mishandled by the RO, or the RO failed to consider it. If the RO had considered this evidence, but decided to deny the claim anyway, then the RO should have explained in the "reason and basis for decision" why this Veteran favorable medical report still did not warrant an approval of benefits.

2. The RO also failed to give an explanatory "reasons and basis" for denial of the Pulmonary Fibrosis when the evidence supports the Veterans claim. (Then list the medical exams and dates that you think support your claim)

3. There is evidence of "shredding" or mishandling of evidence by the RO. Altho the extent of shredding is unknown, regulations require the VA consider all the evidence before a decision is rendered.

Ima Veteran April 13, 2010

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The PTSD claim will need proof of a nexus-if that is why they denied it-

did they mention if JSRRC attempted to validate your stressor?

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The PTSD claim will need proof of a nexus-if that is why they denied it-

did they mention if JSRRC attempted to validate your stressor?

Thanks to all of you who responded. There was no mention if JSRRC attempted to validate my stressors. Nor did they mention buddy letters that I sent in as evidence. The VA did award 10% for depression due to hearing loss and tinnitus. I really believe the VA took the easy way out by awarding the 10% hoping that I drop the PTSD claim. Thanks.

68mustang

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Did they mention the PTSD claim at all in this decision?

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Did they mention the PTSD claim at all in this decision?

Yes they did. The denial states " The examiner states you do not meet the criteria for a diagnosis of PTSD as stated in the the Diagnostic and Statistical Manual of Mental Disorders published by the American

Psychiatric Association. I was assigned a GAF of 65, however the C&P exam states a GAF of 60. There is not much difference, but it is still a mistake along with the omission of some other details that I told the examiner. Like I stated before I was rated for 10% for depression due to hearing loss tinnitus. I think I was rated for that hoping to keep me from going any further on the claim. Thanks.

68mustang

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