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Yet Another Horror Story

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Po'Boy

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Well, its been a month since my C&P exam for a re-rate for PTSD. My treating doc told me to put in for 100% and wrote a letter to the C&P examiner saying I was unemployable and needed my meds to make it thru the day. The exam was 15 min away (Loch Raven) from the hosp.(Balto.) and as of this writing; the report has not made the 15 mile electronic journey to the main regional hosp. or office. (I have been @70% for 17 yrs). After no word and feeling wholly ancy, I called my VA rep here in Md and she had no info for me. I called 202-565-5436 and got a HUMAN who stated that I needed to call Wilmington,DE for more info. She also suggested the (dont laugh) 18008271000 number. I am a MD resident,not DE. She furthered her statement by telling me I have NO claims open. (I have two-one I already had a C&P for). After explaining that I dont live in DE, the rep acted annoyed (as if I dont know what state Im in) and said I need to call the 800 number again. After a call to my rep from Maryland she assured me my paperwork was in state at least. What I did not know is that a "rater" can supercede the opinion of Phd's w/30 plus yrs of VA experience. I have never met any "raters" and only pursued this on the reccomendation of my long time treating doc. So now I sit, wondering where my paperwork really is, and how some "rater" is going to override my treating docs diagnosis. Why is it we have no where to turn? The DS login requires a trip to the regional office which for me is a 3 hr drive-great when gas is 4.00 a gallon. I dont know what to do or where to turn as the right hand doesnt know what the left is doing and my rep just keeps telling me to wait....it usually takes about a year. I am beginning to think I shouldnt have started this process as I am now a bundle of overworked nerves. Out of all this I will say I guess I did it to myself (enlisting) and I need to shut up and take what they dish out. What a mess.

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Po Boy, You need to calm down of course but you know that.

If you want to sign up for ebenefits you can do that now through your my ehealth if you have signed up for that and have been authorized at the eligibility office at your local VAMC. if not go to the eligibility office and get yourself in person accepted. You just need your ID and your pass word.

Remember times are different than 17 years ago when you first filed. The back log is real and the days of claims being granted in under 6 months are indeed rare!

Good luck to you and if you need more help getting signed up the eligibility office is there to help!

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Well, its been a month since my C&P exam for a re-rate for PTSD.

my rep just keeps telling me to wait....it usually takes about a year.

I'd listen to your rep, but will state it will probably be more like 18 months

before any resolve.

Get a hobby or go fishing.

There is NO way to accurately track claim adjudication - the 800 #

can't do it and in most cases neither can ebenefits.

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Thank you for your insight. I really did feel quite alone. Since I live 1 mi from the bay, I will fish and swat mosquitoes til its time to burn firewood again. Bloodworms are going for about 11.00 this year. Thanks again.

I'd listen to your rep, but will state it will probably be more like 18 months

before any resolve.

Get a hobby or go fishing.

There is NO way to accurately track claim adjudication - the 800 #

can't do it and in most cases neither can ebenefits.

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Thank you for your reply. It can be lonesome here in cyberspace. I am going to take carlies advice and get a hobby (fishing). I will still check this site and offer help to others if I am able and update as needed. Thanks again. Its quite re-assuring to know I/we dont have to go this alone.

Po Boy, You need to calm down of course but you know that.

If you want to sign up for ebenefits you can do that now through your my ehealth if you have signed up for that and have been authorized at the eligibility office at your local VAMC. if not go to the eligibility office and get yourself in person accepted. You just need your ID and your pass word.

Remember times are different than 17 years ago when you first filed. The back log is real and the days of claims being granted in under 6 months are indeed rare!

Good luck to you and if you need more help getting signed up the eligibility office is there to help!

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What I did not know is that a "rater" can supercede the opinion of Phd's w/30 plus yrs of VA experience. I have never met any "raters" and only pursued this on the reccomendation of my long time treating doc. So now I sit, wondering where my paperwork really is, and how some "rater" is going to override my treating docs diagnosis.

Po'Boy,

What leads you to believe the above - IMO it is not true.

This is adjudication instruction from M21-1MR

Click on :

http://www.benefits....MS/M21_1MR3.asp

Click on :

Chapter 5 - Evaluating Evidence and making a Decision

Scroll down to the following

styleref "Map Title"5. Medical Evidence, Continued

d. Rejecting Medical Evidence

Unless the historical facts upon which a medical conclusion is based are dubious or untenable,reject medical evidence only on the basis of other medical evidence.

The RSVR may not rely upon his/her own unsubstantiated medical conclusions to reject expert medical evidence provided by the claimant.

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  • HadIt.com Elder

if your treating doc is supporting you for an increase and you are already rated at 70% the VARO could go 2 different routes either 100% schedular or grant 70% TDIU which is paid at the 100% rate because your PTSD prevents you from being employable it is seriously unlikely that they would move to lower your award if your treating doc is supporting an increase yes the claims are taking longer now to go thru the initial claims phase due to the submission of the OIF/OEF claims and now all the claims for the new 3 presumptive AO illnesses IHD being the largest one, a lot of Nam vets have cardiac conditions that are connected to IHD many died before the VA passed the rule last year allowing the cardiac claims then there are many that made cardiac claims years ago that were denied because they claimed there was no evidence AO caused cardiac problems, those veterans are owed a lot of back pay under the Nehmer rules I believe but all those claims have to be reviewed.

do not ever get to the point where you feel you should be happy with "whatever they give you" they are not "giving" you anything, you earned these benefits with your service and by being physically harmed by your service, compensation covers pain and suffering and loss of possible earned wages VA compensation benefits are not a gift or welfare disabled vets are getting what was promised to them when they enlisted or were drafted that famous "PROMISE" nothing more and nothing less they "win" by discouraging veterans from asking for the full benefits they are entitled to and are seeking many VSOs help feed this image by making idiotic statements like you should be happy with what you got, many vets don't get that much, what are you greedy, etc well not all vets are disabled as other vets that is why there are so many different percentages they can award for each medical issue. just like PTSD can be awarded at 10% 30% 50% 70% or 100% veterans can be affected to different levels don't apologize for being disabled as bad as you are, you didn't ask for it the simple fact is now you are disabled and you deserve all the benefits your symptoms and condition qualify you for. Sometimes we have to get IMOs or IMEs to over ride a bad C&P exam or a raters bad decision but that is what the NODs and BVA appeals are for you don't have to accept a bad decision that you feel is wrong.

good luck and I hope they resolve this in your favor as quickly as possible me I was hard headed and fought my cardiac issues from Dec 2002 until June 2009 before the BVA award was granted and I got the back pay because I felt they were SC and the VA didn't it took time and a lot of appeals to different people and 3 IMOs and 1 IME but I was successful the people here gave me the motivation not to quit, I promise you many times during that long period I thought about quitting, but if I had I only would have harmed my family, my wife's potential DIC benefits etc. Sometimes we have to fight for what is right

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