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Dro Ptsd Claims Review Hearing.

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JamesPT

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Hello everyone. Two years ago March 2010 I was awarded a lowball rating for PTSD. I submitted an NOD letter for a review of discrepancies, innacuracies etc observed in their "Reasons for Decision". I requested a review for a higher rating. When I filed for a review I had for several months been seeing and getting counseling\treatment from a private sector Psychiatrist who wrote a very good Nexus letter stating symptoms and gravity of mental condition. I had to seek help from a private sector Psychiatrist because shrinks at the VA do not write support statements for Veterans. This was made very clear to me when I requested a support statement from my VA Psychiatrist, all it took was one word from her "NO!". The frustrating issue is that for the past 5 years I have been under therapy from a VA Social Worker, the Psychiatrist just manages my meds. As I read under "Reasons for Decision" it is apparent that the Social Worker has downplayed the severity of my condition; I imagine when the VA letter refers to "The Examiner" they are referring to the Social Worker. Well, the Nexus letter from the Psychiatrist and his diagnosis for more accurate PTSD condition was very minimally taken as evidence and consideration; they used the VA examiners (The Social Worker I presume) innacurate reports in my opinion as evidence for the lowball rating. I got into a tissy fit with the Social Worker last year, now I am just seeing the VA shrink for meds management. Just yesterday I received a call from VA Regional, they are going to schedule me for a DRO hearing regarding the issues. Does the Nexus letter still carry any weight to make a difference for a fair rating? Criminy, what is bothersome about the claims process, therapy sessions, meetings with Doctors etc; does a Vet have show up for these, unshaven, dirty, disheveled. Seems to me, if you comb your hair, have a clean shirt and pants they may just opine one does not suffer from PTSD condition?. Any suggestions in how to prepare for the DRO hearing would be greatly welcome and appreciated. Thanks.

Jim

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Hello everyone. Two years ago March 2010 I was awarded a lowball rating for PTSD.

Does the Nexus letter still carry any weight to make a difference for a fair rating?

Jim

Jim,

Since you are already SC'd for PTSD - a nexus letter is no longer relevant

as it only used to support a connection of active duty to claimed disability.

To get an increase you need to meet the criteria (with medical evidence)

for a higher evaluation. Your prior rating decision should state what is needed

for a higher evaluation.

Carlie passed away in November 2015 she is missed.

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Hello and thanks for your reply. As you mention in your reply, I am SC'd for PTSD and as you indicate:

"To get an increase you need to meet the criteria (with medical evidence)

for a higher evaluation. Your prior rating decision should state what is needed

for a higher evaluation".

My dilemma is that the Nexus letter I submitted meets the criteria needed for a higher rating, the medical evidence\diagnosis is throughly explained in my Psychiatrist's Nexus letter. The Nexus letter does state what is needed for a higher evaluation. The criteria in the Nexus letter was ignored, their decision was made according to the VA examiner's report. When reviewing the Nexus letter and the Examiner's report the latter report which was used for their lowball decision does not reflect an accurate true diagnosis of my condition. I just don't know how a Psychiatrists diagnosis stacks up to a Social Worker's diagnostic report. I would tend to think a Psychiatrist's medical expertise would outweigh a Social Worker's degree of understanding of the so very complicated PTSD mental condition. I had a similar situation happen in regards to my service connected injuries. The last C&P exam was performed by a Physicians Assistant who was, that particular day substituting for the Phycisian who was off for the week, when he submitted his report it was grossely diagnostically innaccurate; I obtained a copy of his report, presented it to the 3 orthopedic surgeons who have treated me for such injuries for the past 6 years; they wrote 3 Nexus letters indicating the innacuracies and wrong diagnosis of injuries. I have had two surgeries with another one pending later this year. It has been written\documented by Mental Health Doctors that my physical injuries are a major stressor that adversely adds stress to my PTSD condition; the reminder of how these injuries occurred in combat operations, the chronic pain, the surgeries and more pending; and yet nowhere in their "Reasons for Decision" reports do they make mention of the stressor\service connected injuries, (My private sector Psychiatrist brings all of it to their attention in his Nexus letter), I have discussed the issue with the VA therapist numerous times but for whatever reason the've ignored to make comment and the point that these injuries add tremendous stress to mental condition. Regarding my PTSD DRO hearing coming up, anybody have suggestions opinions in how to approach and get ready for the hearing? as I mention, the criteria required was explained in the Nexus letter; unfortunately they disregarded the criteria and used the VA examiners misconstrued reports. Thanks, your help is much appreciated. Just trying to find an angle for the DRO hearing.

Jim

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