ptsd Research Help

[chucknewcomb]

I went to the bussiness office the other day and had them print off a list of all my diagoniss and they have codes out to the side these codes don't seem to correlate to 38cfr. I tried a internet search on one and It wanted me to join a pay site to view the info

here is a example

TRAUM ARTHROPATHY-L/LEG (716.16)

where can i find out about this code and I am about to submit another claim as soon as i get the offical notification that the previous one has been closed .

Here is where I am according to the letter I got from DAV the other day

10% chondromalacia right knee granted 06/15/10

10% bilateral tinnitus granted 06/15/10

10% retro patella pain syndrome left knee is continued

Denied bilateral hearing loss

I also have 2 at 0% but I cant remember what they are for

one was for a skin condition

the other maybe a wart that I had when I got out

I am planning on trying to add

Major Depressive Disorder, Recurrent, Severe (ICD-9-CM 296.30)

PTSD, Chronic (309.81)

Insomnia with Sleep Apnea (ICD-9-CM 781.51)

I am also thinking of fililng a NOD for my left knee

Can I file a NOD while starting a new claim

[chucknewcomb]

after doing a little research i think PTSD may be almost impossible to prove a stressor for as it was for training that simulates combat and the only other person that was there is no longer living.

I wish i had my entire in service medical records but i dont I have requested my omph and it has my seperation physical. In my physical insomnia, and flat feet and problem with ankel is listed but after a BVA search i found this

While the Board notes that insomnia is generally considered a symptom and not a disability capable of service connection, insofar as the RO nonetheless granted service connection the Board is constrained to rate this disability.I want to link insomnia to both sleep apnea and to major depressive disorder since insomnia is a symptom of both. After reading up on all 3 it seems to go hand in hand so how should i write this up :sleep apnea secondary to insomnia and MDD secondary to sleep apnea and insomnia

I havnt yet had a sleep study due to missing a appt in oct should I wait and get that done first or since it will be required of the C and P exam go ahead and file as soon as I get my current claim closed

also who at the hospital should I call to reschedule a referral to a outside sleep study

[john999]

You have to link any secondary conditions to an accepted SC condition. You need medical evidence to make that link.

What are you SC'ed for now?

[chucknewcomb]

Currently 10%retro patella pain syndrome

0% skin condition

0% for something else

According to the DAV these are on the way10% chondromalacia right knee

10% bilateral tinnitus

so there is nothing that i am currently SC for that I could blame as secondary

I have proof of Insomnia from my final physical and there should be plenty about it in my records

since the VA considers Insomnia to be a symptom and not a disability would it be secondary

I am pretty much sure that i can get one of my doctors to write up something about my insomnia is caused by my MDD and Sleep Apnea

[rakkwarrior]

I would review the rating criteria for your SC'd knee condition, then evaluation whether or not you should be rated under arthritis or limitation of ROM, they cant pay your for both, however, should allow for which ever evaluation is higher. In regard to an NOD, you should ask your NSO whether getting another medical opinion is needed or whether or not the rating is in fact correct. Remember you have a year to either reopen or file an appeal. The appeal is the longer road, and effective dates for increased evaluations are based on when it becomes factually ascertainable the increase is warranted.

Be careful, take your time, and make sure you and your NSO work together to be well informed of the facts. You can even print this and take it to your NSO, they should fully understand.

***One more thing, the issue should focus on depression as secondary to your knee condition and associated chronic pain, and reduced activities of daily living and occupation. The PTSD thing may but a bit too difficult to win, given RO attitudes and positions on training issues, unless it involved real fear of death, example parachute/airborne accident, helicopter crash ect.

Once we had two incoming 1.5inch FFR rockets from a Kiowa Warrior hit near our position while on an Air Assault Training while at the 101st airborne Div. Ft. Campbell Kentucky. This would be difficult if not impossible for me to prove as a PTSD stresor, even though I know it happened...and scared the sh** out of me, well in a funny kinda way. Still, for another person it may be their PTSD claim. Depression as due to an SC'd condition is ultimately easier.***

Edited March 20, 2011 by rakkwarrior

[chucknewcomb]

just to recap

started claim on 6/15/10

for

Currently rated 10%

bilateral tinnintis

bilateral hearing loss

right knee secondary to left knee

and tried to raise left knee

went to decision phase on 9/15/10

Notified by DAV on 3/11/11

told i was now at 30%

3/18/11 ebenefits showed notification phase

today 3/21/11 ebenifits says closed letter generator confirms 30%

hopefully I will get the back pay this week my unemployment ran out last week and I dont get my first voc rehab check till the 1st

[rakkwarrior]

just to recap

started claim on 6/15/10

for

Currently rated 10%

bilateral tinnintis

bilateral hearing loss

right knee secondary to left knee

and tried to raise left knee

went to decision phase on 9/15/10

Notified by DAV on 3/11/11

told i was now at 30%

3/18/11 ebenefits showed notification phase

today 3/21/11 ebenifits says closed letter generator confirms 30%

hopefully I will get the back pay this week my unemployment ran out last week and I dont get my first voc rehab check till the 1st

DAV likely reviewed the file, the VA examinations and conceded the 30 percent based on the evidence of record, if you feel as though a higher evaluation is warranted, discuss the Rating Decision with your NSO and prepare a game plan to obtain the evidence to have the case reconsidered, then file under the FDC program via VAF 21-526EZ to have the case re-adjudicated in 90 days or so.

When DAV reviews the file and sends a letter, the NSO has already reviewed the decision, and if required approached the Rating Specialist or Team in regard to the assigned evaluation. We do this in order to ensure the VA does not commit a CUE, and to additionally ensure that prior to the final decision, if there is a difference of opinion, once you follow up when the official notification is sent, we can advise on the evidence required to overturn the decision without appealing.

Traditionally, the only option was to appeal or file a reconsideration which would take still a significant amount of time, working with your NSO will ensure WE develop the claim in order to know what to expect the next time around. Always review what is required for the higher evaluation, and provide said evidence by way of your treating doctor in order to ensure the decision is considered on the specific legal criteria for the next higher evaluation.

Edited March 24, 2011 by rakkwarrior