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File For Cue?


ollieee6

Question

Greetings, I hope that this post finds everyone in high spirits.

Background:

2007- Rated 10% for PTSD

2010- Increased to 30% PTSD.

I currently have a reconsideration claim which is currently at the rating board for an increase in benefits. I receive SSA for my service-connected PTSD, have numerous documents from my VA shrink, stating my disability is severe, and IS the reason im not working, I have submitted this evidence twice, so I'm hoping third times a charm.

I recently received my C-file for the first time, and I never understood why I had been rated so low, when all the evidence was severe, letters from Senators, and Representatives on my behalf, my SSA award letter( but it never stated what my disability was, I contacted SSA and they added the reason being PTSD). All submitted to VA. In reviewing my C-file, I noticed my initial C & P exam (2007) had many errors and wrong information recorded.

All medical evidence was submitted to the VA in 2007, and my diagnosis of PTSD and Bi Polar were also submitted PRIOR to my C & P 2007. I will post some of the questions and responses recorded by the Psychologist.

C & P #1 2007

1. Where there one or more hospitalizations for a mental condition? NO

**I was admitted in 2004 for Personality Disorder/Adjustment disorder as diognoised by VA, spent a week on lockdown, which was recorded in VA file.

2. Legal History? No

** Arrested in 2006 for theft, homeless, and no money for food. (All noted in statement in support of claim sent to Va & referenced to VA by my Senator)

3. Does the patient have panic attacks? NO

** I have severe panic attacks, documented by my VA shrink, emails to my Senator, ect.

4. PTSD initial mental competency:

DOES THE VET KNOW THE AMOUNT OF THEIR INITIAL BENEFIT PAYMENT? YES ** I have not EVER received benefits at this point. This was my initial C & P

DOES THE VET KNOW THE AMOUNTS OF MONTHLY BILLS? YES ** I had no bills, my sister was caring for me.

DOES THE VET PRUDENTLY HANDLE PAYMENTS? YES ** again, had not received benefits

DOES THE VET PERSONALLY HANDLE MONEY AND PAYS BILLS? YES ** had no bills/money

And the list goes on, and on....

C & P #2

Psychologist notes: Veteran is treated for Anxiety Disorder. He has a history of PTSD (per SELF report), history of Chronic Bi Polar (per SELF report)

** I have been officially diognoised since 2007 having PTSD & Bi Polar, its not a self report. diognoised by VA shrink.

what should I do?

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"currently have a reconsideration claim which is currently at the rating board for an increase in benefits. I receive SSA for my service-connected PTSD, have numerous documents from my VA shrink, stating my disability is severe, and IS the reason im not working, I have submitted this evidence twice, so I'm hoping third times a charm."

Did you send then a TDIU 21-8940 form with the reconsideration request?

Under # 18 check Yes and then under # 25 Remarks refer them to separate page and put yur C file, name and address on t and tell them again if the SSA award that you are sayng is "solely" for the PTSD, and tell them the side affects of any of the SC meds, and any other nformation you feel will show that your SC PTSD renders you unable to work.

"All submitted to VA. In reviewing my C-file, I noticed my initial C & P exam (2007) had many errors and wrong information recorded." Did you question these errors formally when you got the decision?Or since, n the Reconsideration Request?

"All medical evidence was submitted to the VA in 2007, and my diagnosis of PTSD and Bi Polar were also submitted PRIOR to my C & P 2007. I will post some of the questions and responses recorded by the Psychologist."

Have you been diagnosed with the bi polar as secondary to the PTSD or aggravated by the PTSD?Is the bi polar mentioned in the SSA award info at all?

"2010- Increased to 30% PTSD." with the retro I feel should might need to obtain an independent medical opinion-

Also if your NOD was filed after June 20,2007 you can obtain an attorney for this.

But the Reconsideraton-if the SSA award is "solely for PTSD" should trigger a TDIU award-when they get the TDIU form.

(Washington V Derwinski)

I will attach it.

VA wont send this form out until they rate a vet at 70% or more.

I have been attaching the form here for years.Regardless of the vet's rating-but depending on their evidence.

"Psychologist notes: Veteran is treated for Anxiety Disorder. He has a history of PTSD (per SELF report), history of Chronic Bi Polar (per SELF report)"

Sounds to me like this doctor didnt have your C file or medical records present at the C & P.

If the VA never listed the SSA evidence, then did you make sure they acknowledge it in the Reconsideration Request-

and make sure you refer to it again (and attach copies any info you have from SSA on the disability)with the TDIU form.

I know very well how the VA will ignore a SSA finding for a SC condition.

In my case they didnt even send SSA the proper authorization forms to obtain the SSA documentation of this award.SSA is actually an independent medical opinion and is probative evidence (which VA knows)but often they fail to obtain those records.

They could have awarded my husband 100% or TDIU for PTSD in his lifetime.His SSA PTSD award was based solely on his VA medical records and it only took a few months at SSA.

6 years after his entitlement date they awarded 100% PTSD. He had been dead for almost 3 years by then.

Did anything regarding your claim trigger the VA to send you an authorization form for those records?

Was a copy of your signed authorization in your C file?

The letters to or from Senators and Congressmen mean nothing to the VA.

TDIU 21-8940.pdf

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I just realised you asked in the topic header about CUE.

If that SSA award is solely for PTSD you could ask them to CUE themselves.As well as the Reconsideration request.

In M21-1 MR there is a section on evidence. It relies on 38 USC 4.3 and 4.6- I have posted info here on it available under Search feature.

The CUE lies in their failure to obtain the SSA records.

I am betting they didn't attempt to obtain them. Your C file will reveal if they did or not.

I have seen plenty of remands from the BVA (meaning the claim has been sitting around for years on appeal) where the BVA had to order the VARO to get probative SSA records.

It is one more way the VA has of stalling a proper award.

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Berta, thanks so much for your prompt response.

When I initially filed for an increase in 2009, they sent me the VCAA notification, along with the applications for TDIU. I filled them out and submitted them. The rep at American Legion told me to hold off on IU request because they would for sure deny me. I asked that the IU request be dropped, and he assured me once I get approved for a higher rating I could pick the IU claim back up. I was rated 10% at the time.

Regarding the mistakes on my C & P exam, I JUST received my C-file on Friday, and read through it and noticed the errors. What should I do? In 2007, my condition was so bad, that my Senator contacted a mental health facility himself and had me placed for treatment. I was homeless with no health insurance or anything to be able to see a doctor. I have emails, letters and all concerning the severity of my condition.

Yes, I was diagnosed with Bi-Polar, as secondary to PTSD. I JUST requested to add it as a secondary service connected. The American Legion rep told me that I would for sure be denied because VA only pays for one mental disorder, but I proceeded with the request. It it now in the production stage.

Reps response:

You are presently service connected for post traumatic stress disorder at 30%. Adding a secondary issue of Bipolar will be denied. The reason it will be denied is that post traumatic stress disorder and bipolar are both classified as mental disorders and the VA will not compensate you for both. They will determine which one is the most severe and award you accordingly. Subsequently, the VA will continue to compensate you for your post traumatic stress disorder at 30%.

I filed for an increase in benefits June 2009

AWARDED 30% March 2010

Filed for reconsideration April 2010

My SSA is for Code 2960 (Affective/Mood Disorders) PTSD/Bi Polar (2007), submitted evidence to VA,, rated me 10% (2007)

I made sure to note it, over and over, in my reconsideration request.

Nothing was in my file indicating that they tried to obtain SSA information.

It was noted that I was denied initially for SSA when I applied. But I submitted documents stating that my SSA reconsideration was approved, which were included in my file, shows date when it was received, 5 months before being rated, but never in the decision.

My current reconsideration claim is at the rating board. Im getting my ducks in a row, and I have been reading this site EVERYDAY, for clues and advise.

When I was officially diagnosed in 2007 I wasn't seeing a VA Doctor. He completed a medical verification form with stated that I was PERMANENTLY unable to work. I submitted to VA.

This doctor has since been moved to VA and is currently my Doctor.

I know that I was extremely under-rated since 2007, Is there anyway I can fight to obtain the proper award dating back to 2007?

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Yes, ask them to CUE themselves and go forward with the reconsideration. Remember the NOD clock is running. If you file a CUE on your own behalf it has to be on a final and unappealed decision as I understand it. Your decision is on appeal and that is the best way to go. You might want your own doctor to review your SMR's and current medical condition and write a report that rebutts what the VA has said and states you are unemployable due soley to your bi-polar/PTSD. An SSD award for a SC condition should be an inferred claim for IU if the VA knew about it. However, if they did not even request the records then that is an error. I sent them my SSD award letter on my own just so it would be in the record. I know it is easier to win claims using the appeal or reconsideration route than to wait and file a CUE, but Berta has had good luck getting the VA to CUE themselves. When did you get the SSD award? Get your IU or 100% first and then worry about an earlier effective date. If I was thinking about big retro I would consider hiring a lawyer after you file a NOD. Let the lawyer worry about fine points of law.

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**I was admitted in 2004 for Personality Disorder/Adjustment disorder as diognoised by VA, spent a week on lockdown, which was recorded in VA file.

Psychologist notes: Veteran is treated for Anxiety Disorder. He has a history of PTSD (per SELF report), history of Chronic Bi Polar (per SELF report)

** I have been officially diognoised since 2007 having PTSD & Bi Polar, its not a self report. diognoised by VA shrink.

Ollie,

You were VERY lucky that VA did not keep you locked into the Personality Disorder.

jmho,

carlie

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John is right about the NOD and about getting a lawyer too.

"The rep at American Legion told me to hold off on IU request because they would for sure deny me." If they eventually award you TDIU and the medical evidence shows it should have gone goes back to the time that this rep told you to drop the IU claim-then -with proof he said that- you could sue him for damages in a state court of law.

Damages that occurred because the EED could have better but the filing date only got you a limited TDIU EED.

There is a vet story at VA Watchdog where the vet successfully sued the rep for the amount of TDIU he lost due to the rep's negligence.

The VA is right-they only pay for one mental disorder.I hope the SSA records are clear as to the PTSD as primary condition but other disabilities are secondary to the PTSD.

Do you have medical evidence that the Affective/Mood Disorder is also clearly due to the SC PTSD?

I think lots of PTSD vets have that. I think my husband did.He was PTSD SC too.

Under certain weather conditions his flashbacks of Vietnam became very intense.

Edited by Berta
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