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Route To Make A Winning Claim...


gbachman
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Question

I am looking to get some services for PTSD while in Fallujah when I was with the Marines, and a couple of deployments since with the Army. I have put it off for a while now, not wanting to be a wuss, but there is something wrong or missing in my life here.

My question for you is this, how would you recommend I go about this? Should I see a civilian doctor, have them diagnosis me, and then go and try to make a claim? Or should I try to make an appointment for a VA doctor, have them diagnosis me, and then go to make a claim. Does it matter? I just want to do it right. I am not looking to get rich by any means; I just want to get it right making the claim and not getting it denied.

Thank you for any info you can give from your experiences.

R/S

GB

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  • HadIt.com Elder

Thanks for your Service and welcome to Hadit.

Go to VA and ask to be seen as soon as you can. No need to go civilian route at this time.

File your claim

When you file ask the VA to review your Military records called SMR's and consider anything that is obvious. Yo also should ask when you go to VA for a Primary Care Doctor and a full physical.

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  • HadIt.com Elder

Go ONLINE, to the VA.gov website, download VA Form 10-10EZ, fill it out and send it to your nearest VA Medical Center. Put a note with the form requesting what Pete just told you about. They will make the appointments and notify you via mail. OR, you can just take the form to your VA Medical Center, to the Eligiblilty Office, and they will process your form and take your picture and give you your VA ID card, thereby establishing your standing as a vet eligible for healthcare, and tell them that you want to be seen, that you want to be assigned a Primary Care Physician, etc.

You might consider getting yourself a veterans service officer (DAV, VVA, VFW, AMER.LEGION, etc.) and some of these may even have offices at your VA Medical Center. They will help you fill out your claims. Or, heck, you can just use the info available to you RIGHT HERE! :biggrin:

According to how adventersome you may be!

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gbachman,

Welcome to Hadit.

When were you discharged ?

You can also start at the Vet Center.

They will sit down and tell you how to get your health care started and they

can also provide 1 on 1 and/or group therapy along with documentation.

For any medications that maybe needed they will help you get set up with a mental health

provider at the VAMC,that is able to write RX's.

They are great and usually located a bit away from the VAMC's.

vetcenter.va.gov

Prior to filing a Form 21-526 - (you only get one chance at filing an original claim)

as suggested, you might want to get a VSO.

Here's a link that explains all about VSO's.

http://www.hadit.com/veterans_service_officer.html'>http://www.hadit.com/veterans_service_officer.html

I would also read thru the following link a few times prior to filing my original claim.

http://www.hadit.com/veterans_self_help_guide.html'>http://www.hadit.com/veterans_self_help_guide.html

Here's a link to definitions and abbreviations you should get familiar with.

http://www.hadit.com/Definitions'>http://www.hadit.com/Definitions

And here's a link to Hadit's homepage where there is tons of great information.

http://www.hadit.com/

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Do you have a combat action ribbon of purple heart medal?

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  • HadIt.com Elder

I have begun advocating the use of the VA Form #21-526EZ. The form for use when turning in a "Fully Developed Claim". And, I know, if you have turned in your very first claim, using the standard VA form #21-526, then it's been stated, and I've used, the VA Form #21-4138 "Statement in support of Claim" for any additional claims after the first one. BUT, for the "Fully Developed Claims" you MUST use the VA Form #21526EZ.

Download the Form 21-526EZ and it will guide you through the process (it's like, 3 pages long, and very quick and easy to fill out). It really should expedite your claim, or, at least, it SHOULD!

You've got to make sure and send in any documentation, INCLUDING your VA Medical Center Progress Notes, any VA Medical Center diagnosis, copy of your DD214 and your Service Medical Records (SMR's) and Service Medical Treatment (SMT's), and, in the case of PTSD I'm going to type up here what I've been talking to the VA, the Dept. of the Navy, and a couple of other sources as to what is needed to make up a good PTSD claim.

Here goes:

1. Be diagnosed by the Department of Veterans Affairs. The PTSD diagnosis MUST come from a psychiatrist OR psychologist either on VA's staff or under contract with the VA. Diagnosis by a PRIVATE doctor OR by a MILITARY doctor IS NOT ENOUGH. (my emphasis added)

2. Indicate on your disability claim that your PTSD is related to a fear of hostile military or terrorist activity, because you experienced, witnessed or were confronted with an event, injury or threat from an acutal or potential incident that involved being under attack.

3. Indicate that your response to the real or threatened event was a state of "fear, helplessness or horror".

4. Ensure that the claimed event or threat is consistent with places and circumstances of military service. (You can't be in the CONUS and claim you were under attack in Afghanistan, obviously.) And, of course, the awarding of the CAB/CAR, PH, or other documentation is always helpful.

For #1 above, the progress notes and the diagnosis (DSM IV) needs to be from a VA professional (MD Psychiatrist or Board Certified Psychologist), and that is ALL that the VA will accept if you are going to go the Fully Developed Claim route.

For #'s 2 and 3 above, I would think that, if your psychiatrist or psychologist notes do not state the required facts in language as indicated, then a properly filled out and signed statement from YOU will have to suffice (VA Form 21-4138, Statement In Support Of Claim).

For #4, the DD214 will, in most cases, be sufficient, as LONG AS it indicates "feet-on-the-ground" in a location conducive to getting yer ass shot off, etc., an MOS also conducive to the proper state of mind and body would most likely help (an assignment as the Admiral's clerk might have been stressful enough to earn the PTSD rating, but, the Admiral might not think so...............).

just sayin.....................................................

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      • See how the details below give us a better understanding of what you’re claiming.
    Rephrase the question: I was involved in a traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?
     
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