ptsd Suggestion(S) On Filing For Increase And Secondary Condition(S)

[TCole70]

I'm trying to to get some guidance on the in's and out's of getting an increase on my current s/c disabilities and the secondary issue(s) that has formed from the treatment of those disabilities. Here's an overview of what I'm dealing with thus far:

I'm currently rated at 60%

1. 20% Herniated Lumbar Discs L5 - S1 - this was intially rated at 30% and reduced to 20% back in August 2004 and I did not Appeal it due to not knowing the proper procedure, I did try the NOD and even attempted to go through my congressman, but it was still denied and I gave up. I didn't even know about a CFile or what Release of Information was. I thought that my SMR was the only medical records I needed. I finally found out about ROI and have copies of my VA Medical History and recently received a copy of my CFile; which has all of the inquiries from that congressional and the evidence that supported the NOD that VA denied, but I don't know how to put it together.

2. 20% Residuals, Right Hand Crushing Injury (dominant hand), Loss of motion in three fingers

3. 20% s/p anterior discetomy and fusion for compressive cervical myelopathy including C5 corpectomy strut graft and anterior plating.

The secondary issue(s) that are documented in my Medical History

1. Lumbago

2. DJD

3. DDD with Schmorl's node and vaccum phenomea and broad based bulging ligamentum annulus at L5/S1 level (findings from CT of Lumbar Spine in March 2011)

4. Chronic Insomina

5. Major Depressive Disorder, Moderate, Recurrent

6. PTSD, Chronic (dx in April 2011, currently attending a weekly PCT Group and consulted to a Track 1 Group)

7. Chronic Constipation

8. GERD - Hital Hernia - r/o lesion gi tract (from Oct 2010 EGD by VA)

9. Hemmoroids - (dx from June 2011 Colonoscopy from GI Specialist referred from VA - 2nd colonoscopy, VA did one in Oct 2010 along with EGD)

10. Chronic numbness in right/left toes - specifically big toes

11. Chronic Weakness/Numbness in right leg

12. Calculus of gallbladder with other cholecystitis (gallbladder surgery Oct 2010)

From my attempts to research the subject matter on here throughout the forum, which has been helpful. I am still lost on what to do. A lot of the legal jargon is frustrating me and there is so much additional information that is confusing me as well. I am doing my best to practice as much as I can on filling out the forms that I come across from the links here, before I take anything in to file. I made the mistake of going in and filing the PTSD claim without doing that and I still haven't heard anything back from the RO about that one. However, when I got a copy of my CFile, I noticed a copy of the VCAA concerning the claim, but I did not get that letter. And it was dated being sent out back in May. How do I address that?

From researching the PTSD requirements on here,

a) I requested a copy of my military files to assist in identifying my stressor (which I got a letter stating that my records or DD214 could not be found)

b) I have statements from family, former co-workers and former employer and former landlords in support of the claim.

c) I am attending all scheduled appointments for treatment and have tried the rounds of perscribed medications (although the Zoloft is ineffective and I have had bad allergic reactions to the other meds - Elavil, Trazodone, Prazosin, Temazopam)

Since VA has that copy of a VCAA letter in their files thinking I received it when I didn't, will that hurt me? Do I need to refile or wait until it gets denied and appeal with the information I have thus far? I have made several attempts through eBenefits, the 800 # and even contacting a rep in person at the RO about this and I just get referred back to one of the three.

Since I am finding evidence in my CFile that the reduction for my herniated disks was without merit on the part of VA, because they stated in my NOD, ("we have not accepted your claim for herniated lumber disks L4-S1 as a Notice of Disagreement because we have NEVER made a decision as to service connection for this condition, because you have previously claimed this condition."); although a copy of the rating decision for that exact s/c condition is in my CFile. How do I address that?

I have tried to research and find a quality VSO or DAV rep here, but have come up with "nada" (only people telling me it's too late to do anything about this or I'm faking).

I'm afraid I'll have to tackle this on my own, and from some of the topics here, it seems like that will be my best bet. I just need some advice on how to word the forms and hopefully they will get to the right person in a timely manner.

I just want to finally get treated with some type of dignity and respect. And finally get the root cause of my disabilities treated the way they were promised.

Any input will be highly appreciated and I thank you all for your service to those of us who have served!

God Bless

[rdawg]

WOW, you have a lot going on. Thanks for your service.

I would take a current copy of my c-file and evidence (medical) of current conditions you think are related to your service or service connected conditions and get a private medical opinion as to whether they are connected to your service. If you submit everything without the IMO and expect the VA to connect the dots your are heading for failure. Stack your deck with an IMO.

As far as the PTSD claim and the missed VCAA. I would submit an IRIS explaining you did not receive the mailing and what is the status of the claim.

You might have to forget about the reduction. It's tough to prove they were wrong.

[brokensoldier244th]

Depression, radiculopathy (numbness), and sleep issues can all be rated separately, though the sleep issues would probably fall under mental health and be tied in with the depression. Provided that you are receiving current treatment (mental, anyway) and have visits to your PCP/Civilian doc it shouldn't be that hard. Write up a 21-4138 (or, a 21-526B, either will do) and explain your situation, why your conditions are worse and how they limit you.Then provide the documentation you have. Certified mail, or hand carry, or fax to your RO. Done.

A VSO shouldn't be telling you you are faking if you have the docs/medical stuff to go with it.

CAS

[TCole70]

WOW, you have a lot going on. Thanks for your service.

I would take a current copy of my c-file and evidence (medical) of current conditions you think are related to your service or service connected conditions and get a private medical opinion as to whether they are connected to your service. If you submit everything without the IMO and expect the VA to connect the dots your are heading for failure. Stack your deck with an IMO.

As far as the PTSD claim and the missed VCAA. I would submit an IRIS explaining you did not receive the mailing and what is the status of the claim.

You might have to forget about the reduction. It's tough to prove they were wrong.

I don't have the money for an IMO and I have only been using the VA for all of my medical care. The only thing that I have that remotely resemble an IMO is a dx from a Board Certifies doctor in Pain Management and Anesthesiology I was sent to under the 120 day grace period while I was on terminal leave. I didn't even have that letter, but it was in the C-File. Can I use that as evidence?

I am hopeful that I can get something positive out the claims without an IMO. I am studying the C.F.R. parts 3 and 4 and using the Progress Notes, dx's from my ER visits and the entries in my SMR that support the criteria.

I already tried IRIS and I still waiting on a response. I've also tried eBenefits as well.

But, thank you so much for your response and your expertise.

[john999]

Why not get a VA lawyer to help you? It won't cost you except as part of your retro.

[TCole70]

Depression, radiculopathy (numbness), and sleep issues can all be rated separately, though the sleep issues would probably fall under mental health and be tied in with the depression. Provided that you are receiving current treatment (mental, anyway) and have visits to your PCP/Civilian doc it shouldn't be that hard. Write up a 21-4138 (or, a 21-526B, either will do) and explain your situation, why your conditions are worse and how they limit you.Then provide the documentation you have. Certified mail, or hand carry, or fax to your RO. Done.

A VSO shouldn't be telling you you are faking if you have the docs/medical stuff to go with it.

CAS

I am receiving current treatment from CAVHCS Mental Health for the PTSD. I don't have a civilian doc though, can't afford one at this time unfortunately. I will take your advice and file the 21-4138 for the MDD, Radiculpathy and Insomina, thanks for clarifying that. So the other conditions will be considered as secondary correct?

It took years and moving to another state to finally get those CT Scans, MRIs, ultrasounds, etc. done; by the grace of God the issues I had through the years are noted in my Progress Notes.

I am not taking any chances and I will hand deliver every claim to the RO.

I've been hearing those "suck it up", "you don't look disabled" or getting laughed at in my face for years now.....I use to get to me which discouraged me and I would give in, but I am learning to overlook it now. I deal with enough stress as it is to allow people like that to continue to deter me. Especially with my finding this forum and understanding that I am not alone in this fight and there are fellow vets that are willing to help.....that goes a long way and I thank you all.

[TCole70]

Why not get a VA lawyer to help you? It won't cost you except as part of your retro.

I'm considering that. I have been listening to the SVR archived radio shows latley and the lawyer I heard speak on there sounded like she really knew her stuff. I wrote down the number to call.

Do you think I will need a lawyer at this point? Thought that was a last resort?