ptsd How Do I File For A Higher Rating?

[JohnO]

I want to file for a higher rating.

I filed for PTSD in May 2010, had a C&P in June 2010. I was awarded 30% effective Jun 1, 2010, in an award letter date stamped Feb 11, 2011.

Since Apr 2011, I've been seeing psychiatrists and psychologists at DeBakey VA Hospital in Houston. My chronic PTSD has been confirmed and I'm currently in treatment in the Trauma Recovery Program, Intensive Outpatient Program.

I've been diagnosed with depression, also.

I sense from my VA mental health doctors that I should be at least 50%. Getting 50% would give me an award over 40% (my current cumulative award right now is 70% (30%+30%+20%+10%)). This would give me what I need to get TDIU. BTW, I have already filed TDIU on Berta's advise from another thread.

How do I file for PTSD increase from 30% to a higher award? NOD or some other type of request that current mental health records be reviewed?

How can I know for sure what is in my mental health file and if I can access those files, how do I do so? I feel uncomfortable talking increased awards, $, with my mental health providers. I feel uncomfortable requesting to see my file.

When is the best time to file? Right now when I am just entering the Intensive Outpatient Program or wait a while? The program lasts 6 weeks. I don't know enough about this entire mental health process and need to learn more. I don't know if I'll be pronounced "better" or "cured" after finishing the program.

I've had numerous nasty medical tests over the years (nerve and muscle biopsies and such) but this mental health thing is stressing me more than any other medical procedure that I've ever had. I'm going in for some new stents this coming week and that is no big deal compared to going down to the VA for a session with the psychiatrist.

[Berta]

As long as you are unemployed,,the TDIU form should cover any request for increase as that is technically what TDIU is- a request for increase to total disability due to unemployability.

However it is best to file the NOD too on the past PTSD decision and tell them of any other evidence you want them to consider that would warrant the higher PTSD rating.They will probably get to the TDIU claim first however.

"How can I know for sure what is in my mental health file and if I can access those files, how do I do so? I feel uncomfortable talking increased awards, $, with my mental health providers. I feel uncomfortable requesting to see my file."

You have every right to get a copy of all of your VA med recs. They are yours. The Records access officer at the VAMC which treats you will have a form you can use or you can simply make a written request for them by mail. "You can state this is a request under FOIA/Privacy Act 5,USC 552 and I request a complete copy of my VA medical records, to include all psychiatric records as this is needed for purpose of a VA claim." And give them your C file number.

You could wait until the Program is over for this request and those records that accumulate but watch out for the NOD one year time limit.

Do you have a vet rep? They might instead suggest a Reconsideration Request but this will not stop the NOD clock,yet you still have time for that type of request and the treatment program records that the outp[atient program will generate could be a big help for a higher rating along with the reconsideration request.

"I don't know if I'll be pronounced "better" or "cured" after finishing the program."

I wouldn't worry about that. VA has to have substantial and compelling evidence that a recent rating for PTSD has improved.There is no cure at all for PTSD. (otherwise the VA would be bending over backwards to treat vets with this 'cure' to save money)

"I'm going in for some new stents this coming week and that is no big deal compared to going down to the VA for a session with the psychiatrist."

Are you sced for this condition requiring the stents? If so -could you be eligible or higher rating on that too?

TDIU- make sure they know how the SC meds you take affects or hinders your ability to work.(like side effects of Do Not Take and Drive, can cause confusion, can cause drowsiness etc)

If VA Voc Rehab ever turned you down solely for SC make sure they know that too.

If you get SSDI solely for VA disability (ies) make sure they know that too.

It isnt too late to add Support for the TDIU claim on a 21-4138 form.

Your docs sound very supportive.

"I sense from my VA mental health doctors that I should be at least 50%" Possibly there is support from them in the med recs that would warrant higher than 30%.

I know how fast retro can go to pay bills and stuff -is there any possibility you could afford an IMO IF the TDIU is denied?

(30%+30%+20%+10%) Along with the 30% for PTSD is it possible that any of these other SCs could be rated higher?

I hope others chime in here as to whether they feel a reconsideration request should be filed or whether they feel the TDIU form will cover the PTSD and potentially produce a TDIU award.

[JohnO]

Thank you, Berta.

"As long as you are unemployed..."

I've been retired-disabled since 1986. I retired because of a motor neuron disease.

"Do you have a vet rep?"

Yes, I used a county vet rep to file the initial claim in May 2010 but have filed all of the remaining requests/responses myself. I have talked with some of the reps at Houston Regional VA but have not used any of them for recent filings. I am not opposed to using a rep. I'll talk with one of the VSOs at Houston Regional VA next time I'm at the hospital.

"Are you sced for this condition requiring the stents?"

Yes, I'm 30% CAD, and my cardio file will support 60%. I'll be filing for an increase soon.

"...any possibility you could afford an IMO IF the TDIU is denied?"

Yes, I still have my independent physicians. All of my physicians practiced at the Houston VA hospital early in their careers. Yes, I can get independent opinions.

Thank you again, Berta for your prompt reply.

[Po'Boy]

My doc told me to put in for 100% for PTSD, I would not have known to do so of my own volition. I completed Voc Rehab, got a couple jobs and lost just as many-all due to my symptoms. My doc wrote a letter and said I was "unemployable" and w/o meds wouldnt be able to take care of myself. I had a C&P exam a month ago and the doc there agreed and said "...you are 100% and permanent...". I have heard nothing since. Im in Maryland in case your wondering-hope this helps.

[Philip Rogers]

My feeling is you should file, a NOD, on you current rating, and file for TDIU and/or 100%. Why file for an increase, when you can increase your present rating, thus preserving you initial award date and perhaps getting more retro money. Remember the VA is supposed to consider TDIU(38 CFR 4.16b) anytime they see the word unemployable. I believe failure to do so would be a CUE. jmo

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