ptsd Smc Housebound For Ptsd Denied

[MikeS]

Hi all:

Rating increased from 70% TDIU for PTSD to 100% scheduler for PTSD with Panic Disorder with Agoraphobia and Depressive Disorder.

Housebound denied.

Housebound was denied because I keep my VAOC appointments. I thought my VAOC appointments do not go against my claim for Housebound.

Housebound was denied because I try to go with my wife to a grocery store once a month. The C&P examiner wrote that I do go to the grocery store once a month but what I told him was that I "try" to go with my wife, "not alone".

Housebound was denied because a recent Progress Note from my VA PTSD Doc said that I go to a gym. What my PTSD VA Doc really wrote was that I tried to go to the gym but I could not stay because I paniced. My VA PTSD Doc failed to put in that note that that was 2 years ago.

You guys might want to know that my Housebound C&P was done by a CRNP. She told me that she had no idea how to explain that a vet with PTSD can be Housebound, so she told me that she just would "cut & paste" my VA PTSD Doc's Progress Notes because she said that he explained my situation better that she ever could. Still, she answered the question: "Can veteran travel beyond current domicile?" as YES.

I only have 60 days from March 27th to appeal the Housebound denial because I signed up for the ECA Initiative.

Any guidance would be appreciated.

P.S. Even though I applied "only" for Housebound, my entire file was reviewed including all Nexus information.

Thanks,

MikeS

[Berta]

"She told me that she had no idea how to explain that a vet with PTSD can be Housebound, so she told me that she just would "cut & paste" my VA PTSD Doc's Progress Notes because she said that he explained my situation better that she ever could.

DUH and double duh- doesn't she know what agoraphobia is?

This is absurd.

I wonder if you can challenge this to get another C & P. If the CRNP has to "Copy and paste" and cannot write an opinion of her own-I think it can be challenged on that basis as she had to 'speculate' by using another medical statement instead of her own.( gee- if she just copies and pastes stuff she could become a de novo review DRO!)

Ridiculous.

Others will chime in.

Did you have any lay statements submitted with the HB claim?

Do your treatment records reveal any panic attacks attributable to the agoraphobia?

"recent Progress Note from my VA PTSD Doc said that I go to a gym" That has to be corrected by the doctor.

[Pete53]

MikeS

Glad you got the 100% and the denial is completely bogus and I think that you know it. I am 100% with agoraphobia and SMC and I go to appointments, occasionally go to out which I have to have someone with me or my dog. Sometimes I don't leave the house for weeks. I also go out to lunch with a friend.

Actually all I think that you really need is a Doc to diagnose agoraphobia to win an appeal on this one.

Fight for it you earned it.

Good Luck

[john999]

These awful C&P exams done by CRNP's are just a scandal. Like Pete says if you have agoraphobia by definition you are housebound. If the NP does not understand this she should be fired.

[MikeS]

"She told me that she had no idea how to explain that a vet with PTSD can be Housebound, so she told me that she just would "cut & paste" my VA PTSD Doc's Progress Notes because she said that he explained my situation better that she ever could.

DUH and double duh- doesn't she know what agoraphobia is?

This is absurd.

I wonder if you can challenge this to get another C & P. If the CRNP has to "Copy and paste" and cannot write an opinion of her own-I think it can be challenged on that basis as she had to 'speculate' by using another medical statement instead of her own.( gee- if she just copies and pastes stuff she could become a de novo review DRO!)

Ridiculous.

Others will chime in.

Did you have any lay statements submitted with the HB claim?

Do your treatment records reveal any panic attacks attributable to the agoraphobia?

"recent Progress Note from my VA PTSD Doc said that I go to a gym" That has to be corrected by the doctor.

[/quot

BERTA:

The nurse did answer the question: "Are there other body parts or system impairments that affect the ability of the veteran to protect self from the daily environment?" YES.

Description of impairment: PTSD, Panic Disorder with Agoraphobia. Right after that statement is when she "cut & pasted" my PTSD VA Doc's notes.

Also, that same DX is present in over 2 years of Progress Notes from my PTSD VA Doc and VA shrink.

[MikeS]

MikeS

Glad you got the 100% and the denial is completely bogus and I think that you know it. I am 100% with agoraphobia and SMC and I go to appointments, occasionally go to out which I have to have someone with me or my dog. Sometimes I don't leave the house for weeks. I also go out to lunch with a friend.

Actually all I think that you really need is a Doc to diagnose agoraphobia to win an appeal on this one.

Fight for it you earned it.

Good Luck

Thanks for the input. I have been DX'd with Panic Disorder with Agoraphobia by the C&P examiner, my VA PTSD Doc, and my VA psychiatrist. No IMO.

[MikeS]

One other thing:

The rating decision ignored a vital part of my Statement in Support of Claim.

I wrote that I had moved to within 1 mile of the VAOPC so that I could more easily make my appointments.

I wrote that I bought a small old house as close to the VAOPC as I could find.

I also wrote that the move put my wife and I into debt and added more monthly costs because we moved from an apartment where we paid no taxes, no water, no sewage, and we did not have to pay for anything that broke.

Frustrating!

Thanks.

Mike S.