ptsd When Should New Evidence Be Submitted?

[handler]

I would like some advice and opinions on when I should submit some new evidence.

To fill you in a little, I submitted claims for IHD, PTSD, and other claims. Received my decision letter and was given a total rating of 60%. IHD 30%, PTSD 30% and a couple 10%. One claim deferred.

I also submitted the form 21-8940 for TDIU which was denied.

I have submitted a NOD (to the DRO) for the PTSD and IU issues and the process is now in the development stage. I did not submit a NOD for the IHD.

Recently I have obtained a great IMO from my cardiologist confirming that I am totally and permanently disable due to my IHD. I also have had some further medical problems and it will reinforce what the doc has written. (I should state at this point SSDI has deemed me permanent/total solely for IHD since 1990 but apparently the VA didn't agree)

My main question is when can/should I submit the new doctor evidence and supporting documents? Now, while the NOD is in the development stage or wait until I am sent the SOC.

Thanks for any advice

handler

[Philip Rogers]

I would submit any probative/favorable evidence ASAP!!!!!! Why would you wait. Not submitting the evidence only slows down the progress but adds to the additional burden of an already backed up system. jmo

pr

I would like some advice and opinions on when I should submit some new evidence.

To fill you in a little, I submitted claims for IHD, PTSD, and other claims. Received my decision letter and was given a total rating of 60%. IHD 30%, PTSD 30% and a couple 10%. One claim deferred.

I also submitted the form 21-8940 for TDIU which was denied.

I have submitted a NOD (to the DRO) for the PTSD and IU issues and the process is now in the development stage. I did not submit a NOD for the IHD.

Recently I have obtained a great IMO from my cardiologist confirming that I am totally and permanently disable due to my IHD. I also have had some further medical problems and it will reinforce what the doc has written. (I should state at this point SSDI has deemed me permanent/total solely for IHD since 1990 but apparently the VA didn't agree)

My main question is when can/should I submit the new doctor evidence and supporting documents? Now, while the NOD is in the development stage or wait until I am sent the SOC.

Thanks for any advice

handler

[sharon]

Since you have an open claim pending, I would submitt a Reconsideration for the IHD. Use the the report as medical evidence for the Reconsideration. If it is not granted you still have your appeal rights.

[Berta]

Sharon is quite right-

This is a situation were a Reconsideration Request is very valid.

It would be great to have a vet rep support this request.

A Reconsideration Request does not stop the NOD clock so while it appears you have plenty of time for NOD_ best to mark your calendar.

With an issue still pending (one claim deferred) this is good time to get this type of request in front of them.

If they were aware of the SSA records and you get SSDI solely for SC I am vewry surprised that was not factored in for a higher IHD rating and TDIU or 100%:

"(I should state at this point SSDI has deemed me permanent/total solely for IHD since 1990 but apparently the VA didn't agree)"

Can you tell us the exact wording in the decision as to how they managed to reject the SSA findings?

Can you scan the decision (cover personal stuff) and attach here ?

With the SSDI award and the cardio opinion , this should warrant a reversal of their past decision on the IHD.

Did your cardio doc conform to the IMO criteria here at hadit and give a full medical rationale for his/her opinion?

[Berta]

To add- handler- I dont get the impression this is a Nehmer claim.

Nehmer only kicks in when IHD was denied in a past VA decision.(Or comes under Footnote One of the Nehmer court Order)

BUT if this IS under Nehmer- have you contacted NVLSP yet?

[handler]

Sharon is quite right-

This is a situation were a Reconsideration Request is very valid.

It would be great to have a vet rep support this request.

A Reconsideration Request does not stop the NOD clock so while it appears you have plenty of time for NOD_ best to mark your calendar.

With an issue still pending (one claim deferred) this is good time to get this type of request in front of them.

If they were aware of the SSA records and you get SSDI solely for SC I am vewry surprised that was not factored in for a higher IHD rating and TDIU or 100%:

"(I should state at this point SSDI has deemed me permanent/total solely for IHD since 1990 but apparently the VA didn't agree)"

Can you tell us the exact wording in the decision as to how they managed to reject the SSA findings?

Can you scan the decision (cover personal stuff) and attach here ?

With the SSDI award and the cardio opinion , this should warrant a reversal of their past decision on the IHD.

Did your cardio doc conform to the IMO criteria here at hadit and give a full medical rationale for his/her opinion?

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Berta,

Thanks to you and others for your responses. Sorry, but I am unable to scan in the documents. I'll try my best to answer your questions.

"Can you tell us the exact wording in the decision as to how they managed to reject the SSA findings?"

With the exception of the SSA records being listed in the "Evidence" section of the Decision Letter, there is no reference to the records or the information in them anywhere in the decision. I should also note that they obtained the SSA records from 1978-2001. That may be because 2001 was the last time SSA did a review of my case and found that I still met their criteria for SSDI.

I just recently received a updated copy of my C-file and the records from SSA are pretty much the same records I sent in as evidence. Same doctor, hospital, lab and test results clearly outlining my condition. I had even submitted the SSA questionnaire and answers from my last SSA eligibility interview.

"Did your cardio doc conform to the IMO criteria here at hadit and give full medical rationale for his/her opinion?"

Here is what he wrote.

"This letter is to document that it is my opinion that your are disable and unable to return to work. You have severe coronary artery disease and have a history of two coronary artery bypass surgeries, the first in 1985 and the second in 2005. You have also had several angiograms and angioplasty and stent procedures performed. You were recently admitted to the hospital because increasingly severe angina with a stress test documenting septal ischemia. An angiogram revealed an isolated septal cascade and al left main stent was placed. You have continued to have ongoing chest discomfort despite aggressive recascularization therapy. You have demonstrated over the years that you have angina at low aerobic stress and occasionally have angina at rest, consistent with the diagnostic category of Canadian class III to IV angina. You have symptoms both with activities of daily living and occasionally at rest and your New York Heart Association functional class is III to IV. On the basis of the above, you are unable to work and permanently disabled."

In the decision letter under the IU denial I believe they solely used the VA examiners opinion. The first line states: Entitlement to individual unemployability is denied because you have not been found unable to secure or follow a substantially gainful occupation as a result of service connected disabilities".

Then the last sentence states: "The VA examiner indicated that your service connected conditions do no prevent you from securing or maintaining gainful light duty employment, including sedentary employment."

Thanks for your time

[handler]

To add- handler- I dont get the impression this is a Nehmer claim.

Nehmer only kicks in when IHD was denied in a past VA decision.(Or comes under Footnote One of the Nehmer court Order)

BUT if this IS under Nehmer- have you contacted NVLSP yet?

Yes, I have contacted NVLSP per your advise in an earlier post and they have said in regards to the decision that it is correct in regards to the effective dates and what they can advise on. There was not an earlier claim submitted.

Edited May 1, 2011 by handler