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BigCountryVet

% Reduction After Increased Diagnosis?

Question

Guys, PLEASE take the time to read all of this. I am at a thinking deadlock with myself. I am still attempting to wrap my mind around this. Back in May I went to Big Spring, TX, for a C&P "re-exam" for my PTSD. This re-eval came 4 years after I had my initial C&P in Jan'06 following my discharge from the Army. Long story short, I got a letter a couple weeks ago explaining to me that the Waco VA was submitting a request for my disability level to be decreased from 70% down to 50%. That letter informed me (much to my surprise and amazement) that my condition(s) have improved over the last four years. In '06 I had the typical symptoms -- knee-jerk reflex when cars backfire & books drop making a loud *pop!*; extreme hypervigilence, always suspecting somebody had something against me personally if i caught them staring; and so on. Now, here in the latter half of 2010, not only do I have those same symptoms, but I stay indoors a large majority of the time just to avoid dealing with busy noisy crowds at places like Wal-Mart, shopping malls and busy restaurants, and my rage control is virtually nonexistent and can only be controlled with a high dose of divalproex among other meds. During this recent May re-exam I was diagnosed with additional diagnoses of Major Depression and also Agorophobia. Fellow Vets, why on earth would they say I warrant a decrease if my issues are clinically worse with additional diagnoses.What's even more interesting is the psych dr i see here in Abilene, TX, let me know I am the most extreme case of ptsd he's seen his entire time in the VA. He is dumbfounded why I'm not the perfect candidate for 100% permanent and total. Any input guys? I would greatly appreciate any feedback on this. I just got my approval letter from the Social Security for unemployability because of my PTSD but now I'm waiting on the appeal process for this messed up VA claim business. Thanks ahead of time guys.

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Guys, PLEASE take the time to read all of this. I am at a thinking deadlock with myself. I am still attempting to wrap my mind around this. Back in May I went to Big Spring, TX, for a C&P "re-exam" for my PTSD. This re-eval came 4 years after I had my initial C&P in Jan'06 following my discharge from the Army. Long story short, I got a letter a couple weeks ago explaining to me that the Waco VA was submitting a request for my disability level to be decreased from 70% down to 50%. That letter informed me (much to my surprise and amazement) that my condition(s) have improved over the last four years. In '06 I had the typical symptoms -- knee-jerk reflex when cars backfire & books drop making a loud *pop!*; extreme hypervigilence, always suspecting somebody had something against me personally if i caught them staring; and so on. Now, here in the latter half of 2010, not only do I have those same symptoms, but I stay indoors a large majority of the time just to avoid dealing with busy noisy crowds at places like Wal-Mart, shopping malls and busy restaurants, and my rage control is virtually nonexistent and can only be controlled with a high dose of divalproex among other meds. During this recent May re-exam I was diagnosed with additional diagnoses of Major Depression and also Agorophobia. Fellow Vets, why on earth would they say I warrant a decrease if my issues are clinically worse with additional diagnoses.What's even more interesting is the psych dr i see here in Abilene, TX, let me know I am the most extreme case of ptsd he's seen his entire time in the VA. He is dumbfounded why I'm not the perfect candidate for 100% permanent and total. Any input guys? I would greatly appreciate any feedback on this. I just got my approval letter from the Social Security for unemployability because of my PTSD but now I'm waiting on the appeal process for this messed up VA claim business. Thanks ahead of time guys.

First, and most importantly do not lose track of the time line. You have 30-60 days to file an appeal. What you need to do is ask for a hearing by submitting a 21-4138 requesting the hearing. It will take them several months to get around to your hearing. Use the time wisely, get a copy of the c&p exam, get your treating psych to write a letter on your behalf, get all the copies of your psych medical records. The hearing is the same as a DRO hearing and infact will be conducted by a DRO. Don't worry just submit the request for hearing ASAP. PM me and I'll give you additional info.

Take care,

Bergie

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1) Immediately file a 21-4138 in response to this proposal to reduce.

2) Then go get that psyc doc to write a statement in support for you with their medical opinion

and submit it - ask for a Hearing in person prior to any reduction in compensation

being put into effect.

Do #1 pronto and get a date stamped copy of what you submit.

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I'm not sure but I think you have 21 days from the date you received the proposed reduction letter to request a hearing. If not done within that time limit the reduction will take place as scheduled and then you'll have to fight to get it back.

pr

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This May 2010 BVA decision says 60 days after receipt of proposed reduction to file an appeal or send more evidence.

"Where the reduction in evaluation of a service-connected

disability is considered warranted and the lower evaluation

would result in a reduction or discontinuance of compensation

payments currently being made, a rating proposing the

reduction or discontinuance will be prepared setting forth

all material facts and reasons. The beneficiary will be

notified at his or her latest address of record of the

contemplated action and furnished detailed reasons therefor,

and will be given 60 days for the presentation of additional

evidence to show that compensation payments should be

continued at their present level. If additional evidence is

not received within that period, final rating action will be

taken and the award will be reduced or discontinued effective

the last day of the month in which a 60-day period from the

date of notice to the beneficiary of the final rating action

expires. 38 C.F.R. § 3.105(e) (2009).

http://www4.va.gov/vetapp10/files2/1017323.txt"

Philip might be right- 21 otr 30 days for a hearing request.

The letter you got should state exactly how much time you have to request hearing etc.

Philip here-I remember this well- helped a vet they wanted to take down to 10% or Zero forget what and he got the vet 100%!!!!

In light of that great advice he gacve that vet--I suggest you either ask for the hearing or get some new evidence to them right away and also attach a TDIU form to the response !

." During this recent May re-exam I was diagnosed with additional diagnoses of Major Depression and also Agorophobia. Fellow Vets, why on earth would they say I warrant a decrease if my issues are clinically worse with additional diagnoses."

Because we desal with sucvh an arbitrary system- I dont think they read your evidence well at all.

"What's even more interesting is the psych dr i see here in Abilene, TX, let me know I am the most extreme case of ptsd he's seen his entire time in the VA. He is dumbfounded why I'm not the perfect candidate for 100% permanent and total."

Has he put that in writing to the VA? Or stated this clearly in the psyche records?

Did VA even have your psychiatric med recs?

"Any input guys? I would greatly appreciate any feedback on this. I just got my approval letter from the Social Security for unemployability because of my PTSD but now I'm waiting on the appeal process for this messed up VA claim business. Thanks ahead of time guys."

If the SSA is solely for PTSD with no NSC findings this is ample evidence for TDIU at the 100% rate of comp.

Did VA have this evidence as to the SSA award when the made their decision? It sounds like you just got it so they could not consider it.

Here is the TDIU form. Under # 18 check yes and then under remarks tell them of the SSA award and attach copy of the SSA award letter. Also under remarks tell them you are requesting consideration of SMC "S" as well due to your agoraphobia which renders you as housebound because of your service connected PTSD.

Tell them of the side affects of any SC meds you take that would hinder employment such as Do not take and drive, causes sleeplessness, or sleeyness ,confusion etc.

"He is dumbfounded why I'm not the perfect candidate for 100% permanent and total" Me too- you can request P & T TDIU as well- and you have the oppotunity to get a higher award than you had because they made a lousy decision here.

Once you take any step to appeal this- as long as it is in their time frame and you have dated proof of mailing your response or request for a hearing -the time frame is stated in the decision letter-they will not reduce (as far as I know) until this matter is resolved.

I know how upsetting this must be for you but in the long run from what I see here they did you a favor- because they owe you TDIU in my opinion.And maybe even SMC "S".

Edited by Berta

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ooops forgot the form.

TDIU 21-8940.pdf

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