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Interesting Movement On Claim

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westcoastlv

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Per EBenefits, there is some new and interesting movement on the claim.

Origianl claim rated last year @ 50% PTSD. My husband and I thought it should be higher, and the DAV suggested filing for an increase, which we did. Then, we decided to file a Reconsideration Request, which stated that if the claim could not be reconsidered, then it should be accepted as a NOD. We faxed it on 10/31/11 (then followed up with certified mail).

I just saw on EBenefits, in the closed claims section, that an Administrative Review was opened on 10/31/11 and closed on 11/14/11. There are no details except it lists all of the documents from the original and increase claims. There is no indication if anything was decided, except that it is now closed and can be appealed.

Has anyone see this before, any indication of what this could mean?

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Per EBenefits, there is some new and interesting movement on the claim.

Origianl claim rated last year @ 50% PTSD. My husband and I thought it should be higher, and the DAV suggested filing for an increase, which we did. Then, we decided to file a Reconsideration Request, which stated that if the claim could not be reconsidered, then it should be accepted as a NOD. We faxed it on 10/31/11 (then followed up with certified mail).

I just saw on EBenefits, in the closed claims section, that an Administrative Review was opened on 10/31/11 and closed on 11/14/11. There are no details except it lists all of the documents from the original and increase claims. There is no indication if anything was decided, except that it is now closed and can be appealed.

Has anyone see this before, any indication of what this could mean?

When you submitted your R4R / NOD, did you also submit additional / updated medical evidence

that completely supported a higher evaluation ?

When you go to ebenefits - What letter's are offered for you to download ?

Carlie passed away in November 2015 she is missed.

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Carlie,

I did submit new evidence, VA Pysch Dr's report that said it should have been a 100% rating, along with all of the reasons why, confirming GAF of 45.

The letter generator only has the Civil Service Preference, 10 point preference and Service Verification letter.

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Carlie,

I did submit new evidence, VA Pysch Dr's report that said it should have been a 100% rating, along with all of the reasons why, confirming GAF of 45.

The letter generator only has the Civil Service Preference, 10 point preference and Service Verification letter.

wc,

Can you post EXACTLY what the VA Pysch Dr's report states and also

was this report in the Evidence of record when the decision was made ?

Carlie passed away in November 2015 she is missed.

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Carlie,

Here are the statements from the Dr's Report, this WAS NOT part of the original claim:

“The examiner (PhD) provides a GAF score of 45 which is used in rating overall psychological, social and occupational functioning of people over 18 years of age, but excludes physical and environmental impairment. Conversely, according to the DSM-IV, a 45 GAF score is supposed to demonstrate serious symptoms OR any serious impairment in social, occupational, or school functioning.”

“Therefore it is a gross misrepresentation of the actual facts of Mr. Veteran’s case to take the above information and then use it to underrate the severity of Mr. Veteran’s service connected PTSD”

“Both the medically qualified C&P Examiner and now myself (another clinically qualified, licensed Psychologist) are in agreement that the SEVERITY of Mr. Veteran’s PTSD should be rated at a Global Assessment of Functioning score of 45, ‘which is indicative of serious symptoms or serious impairment in social, occupational, or school functioning’. This correlates with the 100% SC disability rating of the General Rating Formula for Mental Disorders.”

“Mr. Veteran has not been able to work since 2008 due to the nature, severity and chronicity of his service connected PTSD. He has also been unable to go to school due to the nature, severity and chronicity of his PTSD. This also correlates with the 100% SC disability rating of the General Rating Formula for Mental Disorders.”

“After reviewing the current medical records, it is my professional opinion that Mr. Veteran’s current condition is “more likely than not” related to the in-service condition. Due to the nature, severity and chronicity of Mr. Veteran’s Posttraumatic Stress Disorder (PTSD), it is my professional opinion that he can no longer maintain full-time gainful employment, nor can he sustain effective social relationships. Mr. Veteran’s prognosis for improvement remains poor, therefore his disability should be considered to be permanent.”

The veteran has the following significant barriers to learning: Emotional barriers: comment: severe, chronic, service connected PTSD.

Also, got a call from the VA C&P Examination office today to make a new C&P appointment. Things seem to be moving very quickly, and now my husband has gotten paranoid that they are trying to take his 50% rating away.

Any thoughts??

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Also, looking at EBenefits again today, I see they have opened ANOTHER administrative review, with all of the same documentation as the first. I originally faxed the R2R/NOD dated 10/31/11, and that was the open date on the first Administrative Review, closed on 11/14/11. I then sent it certified mail, and they received it on 11/10/11, which is the date the 2nd Administrative Review was opened, closed on 11/16/11. And then, the C&P Office called to set up another appointment.

Coincidence? I think not.

I called the 800# yesterday and they told me that it looked as if the first Admin Review was opened in error. I'm on hold with them right now to see if they tell me the 2nd was opened in error as well. And the letter generator still doesn't tell me anything except my husband was in the service and that he has preference for civil service exams. (Nothing)

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Origianl claim rated last year @ 50% PTSD. My husband and I thought it should be higher, and the DAV suggested filing for an increase, which we did.

Then, we decided to file a Reconsideration Request, which stated that if the claim could not be reconsidered, then it should be accepted as a NOD.

We faxed it on 10/31/11 (then followed up with certified mail).

What is the date of the rating decision that granted PTSD at 50% ?

Carlie passed away in November 2015 she is missed.

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