ptsd Unsure About Ptsd Claim

[westcoastlv]

My husbad was in the Persian Gulf. His DD214 shows Combat Action Ribbon and Southwest Asia Service Medal w/bronze Star, Kuwait Liberation Medal Saudi Arabia and Kuwait. We have recently (July 2010) filed a claim for PTSD. We have received the VCAA notice, and a letter stating they are still working on the claim. We have a service rep at the VAC who told us that the next letter to expect is to schedule the C&P Exam.

About 5 years ago my husband was diagnosed with BiPolar Disorder by a private psychiatrist. He has been taking medicine for it ever since. Little did we know at the time that the symptoms for Bi Polar and PTSD are very similar, with the exception of the stressor. The private psych didn't ask about any stressors, and we didn't even think there was a connection to the Gulf War. After some research and long thought, we started to pinpoint when my husbands behavior actually began to change. This 'disorder' began during his shore duty, after his time on the ship. He has just started seeing at VA pysch, and we told her about the PTSD, but also had to mention the bipolar (which we said was a misdiagnosis) so that he could keep on his meds. We obtained a copy of his first and only visit with the VA pysch and she mentioned the PTSD and bipolar, had a GAF of 65, and stated that there were some other mental health issues. This has been requested and received by the VA Comp as well. It did not give a definitive diagnosis of PTSD. We have NOT sent any private pysch clinic notes. I spoke with my husbands previous private pysch, and he agrees that his issues are most likely PTSD, but has no notes to that effect because the stressors were never discussed, and he based his diagnosis on what we told him had been previously diagnosed. We have another VA appt tomorrow, and I am thinking that we should stress the PTSD (at least to get it in her notes).

The VAC service rep said that we would most likely get 70% for the PTSD because of the Combat Action Ribbon, but I am concerned that is may not be such a slam dunk. My husband is in desparate need of a rating because he is unable to work. He has an extremely hard time coping with life, even with the medications.

My questions are: should we request that the VA pysch give him a complete PTSD evaluation tomorrow? How does the civilian diagnosis of BiPolar affect the PTSD claim? Or, will this all be resolved in the C&P exam regardless of previous diagnosis? Should we also go to a private pysch and request the PTSD evaluation?

I have written a letter about how my husband's life has been affected by this, and also a letter from him. Who do I show these to?

We've requested other ratings as well: Tinnitus, Bilateral Hearing Loss, and Elbow.

Any advice or insight would be helpful.

[westcoastlv]

I called the 800# yesterday to see if the RO had received the C&P results yet. No, and I was told that the PTSD C&P was sent for a 2nd opinion. This exam was done by an outside provider. I have no idea the reason, if this is good or bad, or anything. We've already filed the TDIU paperwork, so I wonder if that has anything to do with it.

Any opinions of why this PTSD C&P would have been sent for a 2nd opinion would be greatly appreciated. (I can't imagine that the RO would be looking to better the claim)

[pigdriver]

Think positive! Without the report from the 1st examining Dr. it's difficult to give an opinion of "why did they do this"; someone involved in the review process at your RO requested the 2nd "opinion". The VA is currently employing the civilian examiners to move the claims through the pipeline a little faster and apparently its helping. Is your Husband represented by one of the Service Organizations? If so or if not contact the DAV, American Legion etc., there may be a service office at your VAMC. In the ideal world we could file all the claims at the same time but we live in the VA world and you have to file when diagnosed if a disabling condition. Someone will have a good response for you.

I called the 800# yesterday to see if the RO had received the C&P results yet. No, and I was told that the PTSD C&P was sent for a 2nd opinion. This exam was done by an outside provider. I have no idea the reason, if this is good or bad, or anything. We've already filed the TDIU paperwork, so I wonder if that has anything to do with it.

Any opinions of why this PTSD C&P would have been sent for a 2nd opinion would be greatly appreciated. (I can't imagine that the RO would be looking to better the claim)

[Berta]

I have no idea why they would request a second VA opinion unless the first one was too speculative.

But VA usually goes with a speculative opinion because it can stall the claim even more.

"if the GWI exam shows 'issues', will the RO take that into account without us specifically requesting it in the form of a claim?"

No- do not depend on the VA to do that.

The VA focuses on specifically claimed conditions that have a current diagnosis and are claimed as due to service.

I have seen maybe 3-4 times over past decade where the VA will actually take note of a technically unclaimed condition and adjudicate it.In each case they did that-however- there was overwhelming obvious cause to do it.

They need everything spelled out to them like they are ten years old.

I was reading a CAVC decision minutes ago.The veteran said he was told he couldn't file a claim soon after he left the mil.

A successive claim was eventually awarded but he still wanted an EED back to his discharge because of what he was told.

The court did not agree. No formal claim ,no comp.

The GWV regs contain what they VA will service connect in GWVs. Their medical evidence has to match up with the regs to a great extent.

All of that info has been posted here at hadit and these claims -GWV claims- have to be very carefully worded because the GWV regulations are complex.

Edited February 5, 2011 by Berta

[Chuck75]

Yes it happens-- the VA does not want you to know the phone number for the VA person that called you.

So, the awesome 800# called me yesterday, however, I missed the call. I called back to see the purpose of the call, and of course, the rep had no idea. She even suggested that the local Regional Office had called but couldn't explain why the national phone number would have showed on my caller id, not the regional area code. Has this happened to anyone else??

[westcoastlv]

Good Morning Everyone,

I just wanted to update you all on the progress (or lack thereof) on my husbands claim. Here we are, almost March (claimed filed in July 2010) and the local C&P office has yet to send all of the exam results to the RO. And, the RO called me the other day to let me know that once they received everything, it will go to the rater, whose current turnaround timeframe is 5-6 months. I was once told that the rater's decision only took 10-40 days, but now is 5-6 months.

I only felt compelled to comment today because I heard the President talking about how all the new 'VA changes' are making things easier for our Vets. I'm not sure which Vets he's talking about, but it doesn't seem to be the case with my Vet. In fact, before the 'relaxed' standards came about for PTSD the average claim time was 6 mos. We have been in development for 7 months!!

I feel rather deflated because I feel as if I've worked very hard on this claim, locating documents, sending information, making several inquiries, basically being the sqeaky wheel. Now, once it's to the rater, there is nothing to be done but wait, wait, wait.

Thanks everyone, I will keep you posted.

[Papa]

West- My squeaky wheel has come off. I feel for you and your Vet. I wish that I could provide some words of comfort, but all I can offer you is a prayer.

Papa

Good Morning Everyone,

I just wanted to update you all on the progress (or lack thereof) on my husbands claim. Here we are, almost March (claimed filed in July 2010) and the local C&P office has yet to send all of the exam results to the RO. And, the RO called me the other day to let me know that once they received everything, it will go to the rater, whose current turnaround timeframe is 5-6 months. I was once told that the rater's decision only took 10-40 days, but now is 5-6 months.

I only felt compelled to comment today because I heard the President talking about how all the new 'VA changes' are making things easier for our Vets. I'm not sure which Vets he's talking about, but it doesn't seem to be the case with my Vet. In fact, before the 'relaxed' standards came about for PTSD the average claim time was 6 mos. We have been in development for 7 months!!

I feel rather deflated because I feel as if I've worked very hard on this claim, locating documents, sending information, making several inquiries, basically being the sqeaky wheel. Now, once it's to the rater, there is nothing to be done but wait, wait, wait.

Thanks everyone, I will keep you posted.