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File Now Or Wait?

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hedgey

Question

Here's the situation: DH was in severe MVA 35 years ago while in the Army. Severe burns, months in the burn center, lots of scarring & reconstructive surgeries, etc. He's rated SC 80% for scars and burn damage to his shoulder.

He has just started seeing a therapist 6 months ago for his emotional problems, and the VA therapist and two different VA psychiatrists have dx'd him with PTSD. The therapist (as MSW) verified the doctor's dx's, but we still DO NOT have copies of these MH / medical records yet (requested in June & again in August... still waiting!).

His newer VA psychiatrist brought up the possibility of a TBI from the MVA because DH told her about the vehicle rolling 3 times (have copies of extensive reports about the crash, burns, surgeries, etc.).

One minute DH wants to file TODAY because he knows that the clock won't start ticking until he does. But the next minute, DH wants to wait until he has his VAMC / MH records for the last 6 months, with the PTSD diagnosis, in his hand because he's afraid that if he files, the PTSD diagnosis & progress notes might disappear from the VAMC computers...

Also, now there's the issue of possible TBI. The VA psychiatrist told us that she believes he has TBI from his accident (based on what he told her), but it's not definite without further testing.

So this is another "what if?" for my poor DH to try to cope with. What if he does have a TBI? Should he wait until he has that dx to file for both PTSD & TBI? Should they be separate claims or one claim?

My gut says that the PTSD is clear and present and no professional who has spent more than 5 minutes with DH disagrees with that judgment. Plus, the evidence of the trauma is in our hands and literally visible on his hands & face, etc.

TBI, that isn't so clear, is it? I mean, I know they can diagnose it, but I don't believe the medical records say much about concussion, etc, because at the time the focus was on his other injuries, keeping him alive, infection, collapsed lung, broken ribs & shoulder, etc.. Plus it was 30++ years ago. Would they try to say it was from something recent? It's tough to prove that he's been unable to remember things or recognize faces when he has made a point of not having friends and keeping to himself all these years. There's no one he can ask to bear witness... except me, and wouldn't they consider me a biased witness? Do MRI's show when a TBI is old? Does the brain atrophy like a damaged muscle would?

But the record shows that his vehicle hit a bridge abuttment at full highway speed, flipped 3 times, so I don't know, maybe it wouldn't have to be specifically addressed in the medical reports.

Anyway, I'm waffling as badly as he is. The VA rep who helped me isn't in the area anymore, so I don't know what to tell him.

One thing for sure is that I'm very glad he's in therapy. It's hard, because the memories are coming back loud & strong, and it kills me to watch him struggle with it even more than he did. He's been prescribed meds (he really balked at that, but he gave in. He's taking Zoloft... so far not much difference except he's drowsy with it. Same thing with the Lorazepam, though it has helped him get through the day more than once.

I'm sorry to blather on so. It's tough because we have each other, and that's about it. All our parents are gone except his mother, who does NOT understand, never did. I have one brother left that I'm in contact with, but don't talk to him about this stuff. Haven't talked to him more than twice since mom died..

Ack!! I will stop typing now. Just going to restate the question(s):

Should DH file for PTSD now, or wait for his records (he does have his SMRs, just wants his current VA med/mh records). Should he wait until the results are in for TBI and file for both, or should he do them separately?

I'm sorry to go on like this. Thanks for any help...

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  • HadIt.com Elder

File now to secure the effective date. The records will get here when they get here. You know it takes them months to get claims done. The records should be in your hands by then.

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His newer VA psychiatrist brought up the possibility of a TBI from the MVA because DH told her about the vehicle rolling 3 times (have copies of extensive reports about the crash, burns, surgeries, etc.).

Also, now there's the issue of possible TBI. The VA psychiatrist told us that she believes he has TBI from his accident (based on what he told her), but it's not definite without further testing.

So this is another "what if?" for my poor DH to try to cope with. What if he does have a TBI? Should he wait until he has that dx to file for both PTSD & TBI? Should they be separate claims or one claim?

TBI, that isn't so clear, is it? I mean, I know they can diagnose it, but I don't believe the medical records say much about concussion, etc, because at the time the focus was on his other injuries, keeping him alive, infection, collapsed lung, broken ribs & shoulder, etc.. Plus it was 30++ years ago. Would they try to say it was from something recent? It's tough to prove that he's been unable to remember things or recognize faces when he has made a point of not having friends and keeping to himself all these years. There's no one he can ask to bear witness... except me, and wouldn't they consider me a biased witness? Do MRI's show when a TBI is old? Does the brain atrophy like a damaged muscle would?

But the record shows that his vehicle hit a bridge abuttment at full highway speed, flipped 3 times, so I don't know, maybe it wouldn't have to be specifically addressed in the medical reports.

hedgey,

I would go ahead and file at least the claim issue of PTSD.

In regards to the possible TBI from AD, my question would be what

is the resultant RESIDUAL disability from it and would it provide any additional benefits.

IMO - the TBI may not be at all worth putting any energy or concern into -

if there will be no additional benefit.

If PTSD is granted - then it will most likely be at an evaluation percentage (30% or more) that will already

consider occupational, social and memory difficulties.

The VA has taught me to choose my battles wisely - if there will be no additional benefit or secondary

conditions, I leave it alone and enjoy life as I am able.

JMHO

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  • HadIt.com Elder

I agree file for PTSD and leave the TBI out of it it would help if the shrinks would make notes saying that his PTSD is preventing him from working and any other limitations it is creating on his life, how it affects social life, work life and family life

my shrink made it plain that he considered me totally and permanently disabled just by my PTSD symptoms and that I was not expected to ever to be able to return to work he put that statement in my records every Feb since 2003 it wasn't until May 2006 that they rated me at 100% P&T for PTSD but when they did they paid me back to when I filed the claim in Dec 2003

file the claim now so you lock in Oct 2011 for an effective date

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Hello ,,,, I totally agree with the others......I would file for PTSD because of the EED and because it is more rateable , to use a better phrase , than the TBI. Got to get that Earlier Effective Date to start it rolling. Remember that TBI has gone under many denial procedures and is still a new phenomonen to the VA. The raters still don't get it right and the Pyschs may try to NOT link the PTSD but blame it on problems with the TBI incident. It was only a year and half or 2 years ago that the VA was denying TBI as service connected because ,,,,,, "we don't know who set the bomb,,,,,could have been anybody" or something to that effect. Yea right ......like it wasn't the neighborhood milkman...... who cares who set it off ....it blew ,,,killed or maimed in a combat zone is all that needed to be known as statement of fact. I do believe that this type of denial that was used has been put to bed and have not heard of any more denials for TBI having that as an excuse for the denial. But it shows how stupid and reluctant some of these VAROs can be on some issues. If he gets the PTSD grant ,then for the VA to deal with the later filed TBI will have a tougher time of changing the Pyschs opinions because of the later filed TBI.

Hedgey, your soldier can always file later for the TBI as the rules become more clear. The PTSD is one that will not cause as much problems and will get faster results. I also believe that they should be 2 separate claims.File PTSD first and later discuss the TBI once the grant SC for the PTSD is in. Above all though reinforce.......NEVER GIVE UP. God Bless, C.C.

Edited by Capt.Contaminate
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