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Papa

Letter From My Neurologists

Question

Last time I saw my Doctor, was right after I got my rating for my Parkinson's Disease. Which, of course, was 30%. I told my doctor about my rating, and he was surprised in that this disease is and should be rated at only one level, that is a person with this disease is totally unable to work. Therefore, he typed up a letter, and it was sent to the VA. Will this letter help me?

Papa

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5 answers to this question

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Papa,

I'm bumping this one to see if we can get you some answers. Sure hope the doctors letter will help.

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Therefore, he typed up a letter, and it was sent to the VA.

Will this letter help me?

Papa

Papa,

I hope you got a copy of the letter.

No way to speculate on if it will help you without knowing exactly what the letter states

and if the doc's opinion was supported with full medical rationale.

Post it if you can.

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Carlie,

See attachment.

Papa

Papa,

I hope you got a copy of the letter.

No way to speculate on if it will help you without knowing exactly what the letter states

and if the doc's opinion was supported with full medical rationale.

Post it if you can.

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Papa,

Here's a recent BVA decision and I think studying the remand portion

tells exactly what is needed.

Your neuro's letter looks pretty good but if possible could be fine tuned

just a bit.

http://www.va.gov/ve...es3/1124073.txt

ORDERService connection for Parkinson's disease is granted.

Also, throughout the record, the Veteran has argued that he cannot not maintain substantially gainful employment due to his service-connected PTSD with dysthymia and his now service-connected Parkinson's disease.

Specifically, in a November 2006 claim for nonservice-connected pension the Veteran indicated that he stopped working in October 2006.

A claim for TDIU is not a freestanding claim. Rather, it is a claim for an increased rating (a total rating based on individual unemployability) for the underlying disability(ies). Such a claim may be expressly raised or it may be "reasonably raised by the record," and the claim may be filed as a component of an initial claim or as a claim for an increased rating for a service-connected disability.

If a veteran asserts entitlement to a TDIU during the appeal of the initial evaluation assigned, such as in the present case, the issue is part of the underlying claim for an increased initial evaluation. Rice v. Shinseki, 22 Vet. App. 447 (2009).The Board finds that the Veteran has raised the issue of entitlement to a TDIU as part of his claim for a higher rating for the service-connected PTSD with dysthymia. Although they are listed separately on the title page, the issues are not independent and must be adjudicated as one claim. See Rice, 22 Vet. App. at 455.

In the case of a claim for a TDIU, the duty to assist requires that VA obtain an examination which includes an opinion on what effect the Veteran's service connected disabilities have on his ability to work. Friscia v. Brown, 7 Vet. App. 294, 297 (1994).

Accordingly, the case is REMANDED for the following action:

1. Provide the Veteran and his representative appropriate notice with respect to the TDIU issue.

2. Contact the Social Security Administration and obtain any administrative decisions and all medical records used in adjudicating the Veteran's award of disability benefits, specifically those records regarding his PTSD with dysthymia and Parkinson's disease. Once obtained, all documents must be permanently associated with the claims folder. If these records are unobtainable, a negative reply must be noted in writing and associated with the claims file.

3. Schedule the Veteran for a VA examination to identify the current level of impairment resulting from his service-connected PTSD with dysthymia and to obtain an opinion as to whether his service-connected disabilities would as likely as not preclude substantially gainful employment. The Veteran should be properly notified of the examination and of the consequences of a failure to appear. The claims file must be made available to the examiner for review in connection with the examination. All necessary tests should be conducted.

(Papa - This part is what I would want my neuro doc to address in full.)

The examiner should opine as to whether it is at least as likely as not (50 percent probability or more) that the Veteran's service-connected disabilities (PTSD with dysthymia and Parkinson's disease) would prevent him from obtaining or keeping gainful employment for which his education and occupational experience would otherwise qualify him.A complete rationale for all opinions must be provided.

Edited by carlie
additional emphasis and delete computer code and spacing

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Is it possible that this letter triggered the re eval exam you posted about in another topic here?

PTSD is unlike Parkinsons -which is a neurological condition and the VA is supposed to separate neuro conditions from PTSD conditions when they perform C & P exams.

The VA did multiple psychiatric tests on my husband to determine the level of VA brain trauma he had from his CVA that was separate from his PTSD.

The PTSD was 100% SC and the CVA (I am still waiting that rating) should be rated 100% SC.(due to AO IHD or AO DMII.)

Could this be the reason for the recent C & P exam you had?

Then again those multiple tests they gave my husband took two full days at the VAMC.

Carlie gave good advice-the letter is good but needs to be tweaked a little.

If the doctor has no formal Curriculum Vitae (and many never prepare one)

he might be listed at healthgrades.com and for a few bucks at the site, you could print off his medical background so VA knows he has the expertise needed to opine on the claim.

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