ptsd Route To Make A Winning Claim...

[gbachman]

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

[GuaymasJim]

LarryJ, Am I getting this right? If you have a new claim for PTSD, then follow the steps outlined in your post including using VA Form 21-526EZ in order to take advantage of the new VA regulations concerning the presumption of a stressor. If you are appealing an older claim (pre-July 12-13, 2010) then continue to use VA Form 21-4138 to submit additional information. With the new VA Form 21-526EZ claim you need a PTSD dx by a VA provider only, but don't need to provide a "verifiable stressor" if you are a combat veteran. The new regulations basically benefits new claims by presuming the stressor for combat vets but harms them to some degree by requiring a VA provider, and only a VA provider, to make the PTSD dx. An older claim still in the "works" can still rely on an IMO.

Is this accurate?

Thanks.

[LarryJ]

LarryJ, Am I getting this right? If you have a new claim for PTSD, then follow the steps outlined in your post including using VA Form 21-526EZ in order to take advantage of the new "Fully Developed Claim" provisions VA regulations concerning the presumption of a stressor. If you are appealing an older claim (pre-July 12-13, 2010) then continue to use VA Form 21-4138 to submit additional information. Yes.

With the new VA Form 21-526EZ claim you need a PTSD dx by a VA provider only, but don't need to provide a "verifiable stressor" if you are a combat veteran. You still need the "proof" of combat or threatened harm from an enemy. DD214 should provide such proof. The new regulations basically benefits new claims by presuming the stressor for combat vets but harms them to some degree by requiring a VA provider, and only a VA provider, to make the PTSD dx. An older claim still in the "works" can still rely on an IMO.

Is this accurate?

Thanks.

Well, almost accurate.

The NEW form 21-526EZ is for use with ANY new claim (not just PTSD claims) that can be considered a "Fully Developed Claim" (download the form and read the instructions). A "Fully Developed Claim" is ANY claim that is NEW and that you have all the paperwork for, so you can turn this thing in an envelope all at the same time, a claim whereby the VA does NOT have to do any development work to substantiate your claim. You, not the VA, provide all the "stuff" (DD214, SMR's, SMT's, Buddy Statements, Dependent's Status Form, etc.). The MAIN reason that the VA thinks that this will help and will get you a decision more quickly (and, I believe it, also) is the fact that YOU have done all the leg-work. And, TRUST ME, YOU (or your VSO, provided you have one and they are GOOD) can get this stuff from the VA, the DOD, the National Archives, etc., MUCH, MUCH faster than the VA can, because YOU, unlike some clerk at the VA, are NOT going to let YOUR claim turn to dust lying in someone's "IN" basket. I figure it should cut off upwards of 3 + months of waiting (guesstimate ONLY).

AND, in instances whereby YOU need a diagnosis from a doctor (such as for the PTSD), then you can use a VA doctor, such as is REQUIRED for a diagnosis for PTSD, and, if the VA doctor that is treating you has listed in your "Progress Notes" the diagnosis and the prognosis, then, with that information you should be "In Like Flynn".

Bearing in mind that you can use an IMO/IME from a PRIVATE PHYSICIAN/MEDICAL PROFESSIONAL for most any OTHER disability claim OTHER THAN for PTSD. FOR PTSD YOU MUST USE A VA MEDICAL PROFESSIONAL and that medical professional MUST be a PSYCHIATRIST OR PSYCHOLOGIST (no Nurse Practitioners, Physicians Assistant, etc.).

Again, FOR PTSD DIAGNOSIS YOU MUST USE THE VA. So, if you are not "in the system" with the VA and you have NOT been diagnosed with PTSD by a VA MD-Psychiatrist or Board-Certified Psychologist..........then you HAVE NOT BEEN DIAGNOSED with PTSD regardless of what your PRIVATE doctor has said or written..........so, if you have been relying upon a PRIVATE medical professional to provide you with diagnosis and treatment for PTSD.......and you have NO such diagnosis or treatment records AT THE VA, then you have NOT established a "Earliest Effective Date" with the VA, and the VA will NOT, WILL NOT, WILL NOT, pay you retroactively to some date back when you were supposedly diagnosed with PTSD by a PRIVATE PHYSICIAN/PSYCHOLOGIST.

Ah-hah, there is gonna be a passel of vets that are gonna get hit right between the eyes with this, in the not-to-distant future!

Now, I hope that someone will be kind enough to copy and paste this where more folks can see it.

I'm gonna go BBQ another of my neighbor's goats (he's gonna start wondering what's happening with his goats, I'll bet................).