ptsd Ptsd Stressor Denial-Possible Cue

[GuaymasJim]

I have read about all I can about Clear and Unmistakable Error (CUE) claims, but the PTSD claim I am assisting with has presented a situation where I cannot determine if it is a CUE or just a rating error requiring a NOD and appeal.

The veteran has repeatedly (12 years and counting) been denied service connected PTSD for lack of a verifiable stressor. In the Statement of the Case (SOC) and subsequent Supplemental (SSOC), the rater acknowledges that the incident occurred. A buddy letter confirms that veteran was present at the incident. However, according to the SOC, since neither the veteran nor the “buddy” was listed among those injured at the incident and since the buddy had not submitted a claim for service connected PTSD, the claimed stressor did not meet the DSM-IV criteria. The claim for service-connection for the veteran’s VA diagnosed PTSD was denied for not having met the DSM-IV requirements even though the rater’s own words show that it does.

As we all know DSM-IV requires:

Criterion A: stressor

The person has been exposed to a traumatic event in which both of the following have been present:

1. The person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others.

2. The person's response involved intense fear, helplessness, or horror.

QUESTION: Is the failure of the rater to correctly address and apply the DSM-IV criteria to the rating a CUE, or is it just another example of sloppy adjudication?

QUESTION: How would the retroactive award of a USMC Combat Action Ribbon affect an old PTSD claim which was also denied based on lack of stressor and not appealed?

Thank you

[Commander Bob]

Sorry for the side track, GuaymasJim. I believe Philip Rogers & 'stillhere' addressed your question earlier.

Also, with the new PTSD rules, doing away with a specific stressor, the injury part is moot.

All that is now needed is;“fear of hostile military or terrorist activity and is consistent with the places, types and circumstances of the veteran’s service,”

Here is a link:

http://www.defense.gov/news/newsarticle.aspx?id=59987

JMHO...File a NOD

Old Texas saying " we cleared the swamps to get rid of the alligators... not to start an alligator farm"

Edited July 23, 2010 by Commander Bob

[MikeR]

Sorry for the side track, GuaymasJim. I believe Philip Rogers & 'stillhere' addressed your question earlier.

Also, with the new PTSD rules, doing away with a specific stressor, the injury part is moot.

All that is now needed is;“fear of hostile military or terrorist activity and is consistent with the places, types and circumstances of the veteran’s service,”

Here is a link:

http://www.defense.g...e.aspx?id=59987

JMHO...File a NOD

Old Texas saying " we cleared the swamps to get rid of the alligators... not to start an alligator farm"

How long has it been since they denied the claim?

[GuaymasJim]

MikeR: As recently as July 02, 2010.

stillhere: The main problem is that he filed a Form 9 appeal in January 06 which was never logged into the system but was included in the C-file copy. He filed another Form 9 appeal in December 2006 which was received and logged, and is referred to in the July 02, 2010 SSOC as the "Last Adjudicative Action.". Both times he checked the personal hearing at local VA facility in person. After literally years of waiting for the hearing, he finally sent an IRIS to VACO asking for the status of his appeal and personal hearing. IRISes were exchanged with the bottom line being that the appeal was never forwarded to the Board and it still hasn't been forwarded as of today more than 1308/1660 days since he appealed.

His denials at various stages have consistently cited no verifiable stressor. The veteran personally wrote to JSRRC last year and as a result the RO received a verification letter absolutely without doubt supporting his claim on November 19, 2009. The veteran mistakenly believed that the verification letter had gone to the Board . Since the appeal had never been forwarded to the Board, it went to the RO. The RO scheduled another C&P with the result being a 12-year continuous PTSD diagnosis changed to Personality Disorder, Depression, Anxiety.

For 12 years the veteran has been denied SC PTSD based on lack of verifiable stressor. Now, when his stressor is verified, the RO denies SC PTSD despite the verification, and changes his diagnosis. According to the SSOC, the veteran does not suffer from PTSD but suffers from a Personality Disorder NOS.

2002: PTSD Yes STRESSOR No Denied

2003: PTSD Yes STRESSOR No Denied

2004: PTSD Yes STRESSOR No Denied

2005: PTSD Yes STRESSOR No Denied

2006: PTSD Yes STRESSOR No Denied

2007: PTSD Yes STRESSOR No Denied

2008: PTSD Yes STRESSOR No Denied

2009: STRESSOR verified by JSRRC

2010: PTSD No STRESSOR Yes Denied

Yes stillhere, something is really wrong with the claim.

The veteran does not want to waste another 4 years waiting for the RO to act. His NODs are either lost, ignored and/or not acted upon. He just wants his in-person traveling Board hearing, the opportunity to present his claim followed by a decision on his appeal. I believe he is well within his rights.

This claim is driving me crazy and for me that is a very short trip!

Edited July 23, 2010 by GuaymasJim

[Philip Rogers]

CB - I would give it a try, if you are now rated for PTSD. It may be very difficult but could be possible. They can't rate for PTSD, since PTSD wasn't around until 1980, but PTSD is an anxiety related disorder, so it may be possible. You'd probably win 10% retro, if you win, but 10% times many yrs is a nice check. jmo

pr

First, Thank you, PR, for all the help you have given to so many vets and members here at Hadit...

I am seeking an eed for PTSD back to 1968. I see on an old 21-6796b (rating decision sheet) from 1975, there is an ambiguous Code# 9400 (anxiety) NSC rating listed. Since PTSD did not enter the DSM-IV until 1980, could I still ask the VA to declare a CUE?

How is the VA handling old PTSD issues?

Thanks for any feedback or thoughts.

[Philip Rogers]

Misapplication is a CUE. To the best of my knowledge a verified stressor is not a requirement for SSDI.

pr

This thread seems to have been hijacked, but no problem.

The original question is this:

The veteran has VA diagnosis:

Axis I: PTSD, chronic

The SOC denying service-connection states that since the veteran was not injured, the stressor is not valid for service-connection.

Since the DSM-IV makes no mention of "injured" as a criterion. The DSM-IV only requires that "(T)he person has been exposed to a traumatic event" and that "(T)he person has experienced, witnessed, or been confronted with an event or events..."

Again, THE RATER stated in the SOC that because the veteran was "not listed among the injured" the claimed stressor was insufficient.

The C&P examiner did not discount the stressor and neither did the Social Security Administration which awarded SSDI based on the VA's diagnosis including the claimed stressor.

It is obvious that THE RATER misapplied the DSM-IV criteria and stated the misapplication in the SOC and denied the claim based on this misapplication. VA regulations (laws) require an award of service-connected PTSD to any veteran who meets the DSM-IV criteria.

The veteran met (meets) the DSM-IV criteria, but the VA denied his claim.

Is this a CUE?

[MikeR]

MikeR: As recently as July 02, 2010.

stillhere: The main problem is that he filed a Form 9 appeal in January 06 which was never logged into the system but was included in the C-file copy. He filed another Form 9 appeal in December 2006 which was received and logged, and is referred to in the July 02, 2010 SSOC as the "Last Adjudicative Action.". Both times he checked the personal hearing at local VA facility in person. After literally years of waiting for the hearing, he finally sent an IRIS to VACO asking for the status of his appeal and personal hearing. IRISes were exchanged with the bottom line being that the appeal was never forwarded to the Board and it still hasn't been forwarded as of today more than 1308/1660 days since he appealed.

His denials at various stages have consistently cited no verifiable stressor. The veteran personally wrote to JSRRC last year and as a result the RO received a verification letter absolutely without doubt supporting his claim on November 19, 2009. The veteran mistakenly believed that the verification letter had gone to the Board . Since the appeal had never been forwarded to the Board, it went to the RO. The RO scheduled another C&P with the result being a 12-year continuous PTSD diagnosis changed to Personality Disorder, Depression, Anxiety.

For 12 years the veteran has been denied SC PTSD based on lack of verifiable stressor. Now, when his stressor is verified, the RO denies SC PTSD despite the verification, and changes his diagnosis. According to the SSOC, the veteran does not suffer from PTSD but suffers from a Personality Disorder NOS.

2002: PTSD Yes STRESSOR No Denied

2003: PTSD Yes STRESSOR No Denied

2004: PTSD Yes STRESSOR No Denied

2005: PTSD Yes STRESSOR No Denied

2006: PTSD Yes STRESSOR No Denied

2007: PTSD Yes STRESSOR No Denied

2008: PTSD Yes STRESSOR No Denied

2009: STRESSOR verified by JSRRC

2010: PTSD No STRESSOR Yes Denied

Yes stillhere, something is really wrong with the claim.

The veteran does not want to waste another 4 years waiting for the RO to act. His NODs are either lost, ignored and/or not acted upon. He just wants his in-person traveling Board hearing, the opportunity to present his claim followed by a decision on his appeal. I believe he is well within his rights.

This claim is driving me crazy and for me that is a very short trip!

Ok, that seems like a typical VA story. Now that you have a stressor deny that you have PTSD. I think as long as the VA thought you could not prove a stressor it was ok to treat us for PTSD, cheaper that way. That way they could admit we had it without paying us.