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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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TracyK

Dro Appeal For Tdiu Denied Then Mh Diagnosis Changed

Question

Hi All,

I'm a newbie that was sent here by my brother-in-law. He received a tremendous amount of help from Berta on his TDIU claim and was eventually successul - so on his behalf I thank all of you for helping him and hope you can now help me.

I am currently 60% SC. October 2008 applied for TDIU. Initially upfront denied because I did not meet schedular requirements of either 70% SC or one SC rating of 40% or higher. (I am 30%, 30% and 10%) I appealed to DRO, she ordered new C&P's. I have been receiving treatment through the VA for the last 2 years for my 30% SC Depression rating. Having not had a C&P for the last 20+ years, the DRO thought it likely that a new C&P would show that the condition had worsened. She wanted to address meeting the schedular requirements within the same appeal for TDIU.

What I found out at the C&P was that my psychiatrist had neglected to properly annotate my file with the severity of my condition. I pleaded with the reviewer to hear me and to accurately document my condition. He listened and I thought it went in my favor.

Last Friday I got the denial and was shocked! No increase and up front denial of TDIU for not meeting schedular requirements. I immediately appealed to BVA.

Today I met with a new psychiatrist and he has determined that I have been misdiagnosed all this time and that I actually have bipolar disorder.

What is the best thing for me to do now? I appreciate any help you can give me!

TracyK

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"Today I met with a new psychiatrist and he has determined that I have been misdiagnosed all this time and that I actually have bipolar disorder."

Did he link your bi polar directly to your service or to your service connected depression?

Did he change your medication?

Would he be willing to provide a medical statement that reflects the new diagnosis, that it is directly due to your service or to the depression and that it should be re evaluated?

You could ask the DRO to Reconsider their decision with any new and relevant info from this new doctor.

Although you filled out the I-9 BVA appeal form- the claim wont be getting to the BVA to fast and yo have time- with sgnificant evidence to request a reconsideration of the DRO's decision.

Do you have a copy of the actual C & P results to show the new psychiatrist?

Would the new bi polar diagnosis -in his opinion- warrant a different rating?

Is this a VA doctor or a private new doctor?

The ratings for any mental health issue are determined by medical evidence.However other evidence as well can come into play. Any performance appraisals of past on the job behaviors can often help a TDIU claim.

One of my best friends is 100% P & T SC for bi polar.It was his inservice personnel records (not his SMRs)that helped him gain this award.His VA shrink agreed.

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Hi Berta - you are actually the lady who most helped my brother-in law!:biggrin:

Please see my answers below

"Today I met with a new psychiatrist and he has determined that I have been misdiagnosed all this time and that I actually have bipolar disorder."

Did he link your bi polar directly to your service or to your service connected depression?

He said that the the major depression I am SC for is actually bipolar disorder and notated my file of the correct diagnosis for the service-connected mental health condition.

Did he change your medication? Yes. I was on Prozac and still very, very depressed so he put me back on zoloft and added lithium.

Would he be willing to provide a medical statement that reflects the new diagnosis, that it is directly due to your service or to the depression and that it should be re evaluated? I believe that he would. He did a whole lot of notating in my file while I was with him.

You could ask the DRO to Reconsider their decision with any new and relevant info from this new doctor.

How should I go about doing that? By letter?

Although you filled out the I-9 BVA appeal form- the claim wont be getting to the BVA to fast and yo have time- with sgnificant evidence to request a reconsideration of the DRO's decision.

Do you have a copy of the actual C & P results to show the new psychiatrist? I have requested my c-file

Would the new bi polar diagnosis -in his opinion- warrant a different rating? Definitely have to ask

Is this a VA doctor or a private new doctor? New VA shrink, the old one was a nightmare.

The ratings for any mental health issue are determined by medical evidence.However other evidence as well can come into play. Any performance appraisals of past on the job behaviors can often help a TDIU claim.

One of my best friends is 100% P & T SC for bi polar.It was his inservice personnel records (not his SMRs)that helped him gain this award.His VA shrink agreed.

If push comes to shove there is something in my service records I can use. One month I was Airman of the Month...the very next month I got an Article 15 for insubordination when I had never been in trouble before!

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Can you answer this for me? I was diagnosed with obstructive sleep apnea by a private doctor 4 years ago. I cannot tolerate the mask so I have been suffering. Until my medical C &P the VA did not know about this. The Dr that did my C&P was a neurologist, saw my palate and said he wouldn't be surprised if I had it - I told him that I did...he noted it in my C & P.

I told my Primary Dr about it at checkup and asked her to send a consult to the sleep lab so I could now be seen thru VA...she did, I'm on wait list.

Now, I have recently discovered that the SC mental health issue and the treatment I have been receiving for it are "more likely than not" having an effect on the severity of my sleep apnea. I think it is likely that it could be a secondary issue to the mental health rating and therefore be service-connected and rated. I can go get my records from my private doc and I'll be he will be willing to write exactly that statement for me.

How can I get this considered in my current claim? Can I get it in as new evidence, along with the new diagnosis as a way to try to get the DRO to reconsider?

I get a headache just thinking about this stuff!

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Even though it may take a while to get your C File you can go to the VA and review it with a VA Councilor. Some of the RO require an appointment but so few vets do it at Waco that you can usually do it just walking in. I would call 800 827 1000 and ask for an appointment.

I did this a couple of times with other Veterans and they were able to get copies of documents they needed and a dialogue with the Councilor helped speed up their claim.

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"I am currently 60% SC. October 2008 applied for TDIU. Initially upfront denied because I did not meet schedular requirements of either 70% SC or one SC rating of 40% or higher. (I am 30%, 30% and 10%) I appealed to DRO, she ordered new C&P's.

I have been receiving treatment through the VA for the last 2 years for my 30% SC Depression rating. Having not had a C&P for the last 20+ years, the DRO thought it likely that a new C&P would show that the condition had worsened. She wanted to address meeting the schedular requirements within the same appeal for TDIU.

What I found out at the C&P was that my psychiatrist had neglected to properly annotate my file with the severity of my condition."

Questions:

When were you granted your 60 % SC ?

If the 3 disabilities were granted on one Rating Decision, what exactly did that

Rating Decision state in the Evidence and Reasons and Bases Section ?

You are 30 % SC for depression.

You are 30 % SC for ___________.

You are 10 % SC for ___________.

What treatment had you been receiving through the VA for the last 2 years and during this time did you receive any

one on one therapy or group therapy, or mental health services from a Vet Center, or private treatment ?

The reason I ask this is because generally speaking, absent some very special circumstance's, Psychiatrist's at the VAMC's

do not provide therapy or treatment other than the basic quarterly 15 minute appointment for medication management, or

an initial mental health evaluation in response to a referral from another VAMC doctor.

"I pleaded with the reviewer to hear me and to accurately document my condition. He listened and I thought it went in my favor.

Last Friday I got the denial and was shocked! No increase and up front denial of TDIU for not meeting schedular requirements."

Question:

What exactly is stated in the Evidence and Reasons and Bases Sections of the Rating Decision ?

"I immediately appealed to BVA."

Question:

So you have completely filled out and submitted a Form 9 - Substantive Appeal to the BVA.

What did you state on your Form 9 ?

Did you mail it in RRR or submit it in person and get a date stamped copy ?

"Today I met with a new psychiatrist and he has determined that I have been misdiagnosed all this time and that I actually have bipolar disorder."

Information and a Question:

The VBA only compensates for one mental health disability. All of the different mental health disabilities fall under the same criteria in regards

to what percentage is granted.

Very often a person will have more than one mental health disorder an example could be PTSD and Panic Disorder.

When this is the case the two mental health disorders are referred to as comorbid.

Whether a vet has comorbid service connected MH disorders or a single MH disorder, the VA is to provide the highest rating allowed by the

medical evidence of record which is measured by Occupational and Social impairments.

What type of testing did your "new psychiatrist" do ?

A change in your MH diagnosis may change the medications you are RX'd but it will not change the percentage you are compensated at.

Someone else has already posted the different percentage criteria's for you.

Have you requested a copy of all of your VAMC records ?

"What is the best thing for me to do now? "

Answer:

If you have just filed your appeal to the BVA you should more likely than not have plenty of time to get copies of your treatment / therapy records.

I would be sure to request any and all MH records, C&P exams, and the progress notes from your new "psychiatrist".

carlie

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