ptsd Not Sure If Im Doing This Nod Correct

[believe]

This is more than a little bit of information so whoever takes the time to figure it out .. thanks :)

Claimed filed July 2010 for PTSD and agoraphobia.

Denied around November 2010.

Did NOD requesting DRO review. Sent additional medical evidence, including overwhelming evidence I was housebound, around May 2011.

C&P exam July 2012 with notes stating Im housebound

Awarded 100% September 2012 without SMC S housebound which I thought I would get even though I didnt file claim for that because I didn't know I had to.

Called the 800 number the next day after I got my 100% notice. They said I had to file a claim for housebound and thats the reason it was not given to me (I didnt know at the time but obviously thats not true).

Filed new claim for housebound and P&T in September 2012. Provided all of my medical records from my PTSD claim stating Im housebound plus new evidence stating Im permanently confined to my home because of my condition.

January 2013 I was denied housebound and permanent because they stated "You do not meet the schedular requirements for statutory HB nor does the evidence show you are HB in-fact, since the evidence does not show your degree of panic or agoraphobia to be likely permanent throughout your lifetime." My September 2012 100% decision from DRO stated I was likely to improve (none of my medical records indicate that) so that is why I provided the additional medical evidence with my housebound and P&T claim stating I was permanent because my medical evidence with my PTSD claim did not state I was or wasnt permanent.

With all of that being said, I did a NOD for my January 2013 housebound and P&T denial, stating why housebound should have been inferred with my 100% decision in September 2012 for my claim from 2010. Should I have instead did another NOD or filed a BVA appeal for my claim from 2010 because I feel housebound should have been inferred with that claim?

[Philip Rogers]

believe - I believe you should file a NOD on the September 2012 award (2010 claim), otherwise you'll lose 2+yrs of award when you win. Your current NOD may suffice. If they awarded you 100% schedular, strictly due to PTSD, you do meet the "inferred" requirement. You would then need to show evidence of your agoraphobia or the fact that your PTSD prevents you from leaving the house to go to and from work, daily or enough that you couldn't hold down a job.

Could you post your 9/12 decision and your 1/13 NOD, with your personal block out?? Once we see that, we may be able to tell if your current NOD is sufficient, which it may be. jmo

pr

Edited January 27, 2013 by Philip Rogers

[believe]

I already sent them 3 different letters :-/ I guess Im not to good at writing. Here is the first ....

Notice of disagreement January 22, 2013

I am requesting this disagreement be reviewed by a Decision Review Officer

I disagree with the decision dated January 17th 2013 for my housebound and permanently disabled claim. My C&P examiner for the exam in July 2012 did not mention in my records that my condition is likely to improve and none of my doctor medical records say that. My C&P exam records from July 2012 is actually evidence of how severe my agoraphobia and PTSD is and that I am in-fact "housebound". Their reports are indicative that my coniditon is not likely to improve.

My C&P exam performed July 2012 states that I am in-fact "housebound". It also states that "Sense of foreshortened future (e.g., does not expect to have career, marriage, children or a normal life span)".

The VA states that an October 2012 fill in the blank and checkmark examination for housebound was received but it does not show that my current impairment is like (maybe they meant to say "likely") to be permanent and no subsequent medical evidence has been submitted for review. That is not true because additional evidence from my psychologist was submitted and the VA informed me that it was received on December 5, 2012. A part of the statement from my psychologist in that additional evidence states that "Consequently he is permanently and substantially confined to his immediate premises."

Also my denial letter states that evidence does not show that I am housebound in-fact. That is also not true. The letter my doctor wrote dated October 1, 2012 and the letter he wrote dated 4/26/2011 both are evidence I am housebound. Plus my records from my July 2012 C&P exam for my current diagnosis of chronic PTSD and extreme agoraphobia states that "(Axis IV - Psychosocial and Environmental Problems (describe, if any): social alienation, underemployment, "housebound", limited access to health care." I believe I should have been considered for and granted housebound with the 100% decision rating I got dated 9/18/2012 for my PTSD and agoraphobia claim because of my medical records prior to that date and my C&P exam in July 2012 which are clear indications that I am housebound.

I am asking for the enclosed overwhelming medical evidence and documentations that I will be submitting again, which was also submitted with my initial housebound claim and additional evidence, be reviewed and used to reevaluate my claim for housebound and being permenantly disabled.

The denial letter dated 1/17/2013 says "a search today of your local VA medical center's electronic records show no visits for your PTSD". You wont find any other medical reports about me from the VA medical center because I can't go in public to the VA to get treatment because my condition is so severe. I was diagnosed "extreme" agoraphobia. That alone is enough to know I am housebound. That is what my C&P exam means on the part that says "limited access to health care". I asked if there was a way for the VA to assist me telecounceling but that request was not granted. Therefore I am continuing my treatment via telecounceling with my psychologist who does not work within the VA. I have been paying him out of pocket for each therapy session for years and I also pay out of pocket for my meds. Unless it is absolutely required and unless it is for extreme circumstances like for a C&P exam, I will not go in public around people.

Here is the second letter I sent ....

January 24, 2013

This letter should be added to my notice of disagreement letter dated January, 22 2013

For me to be granted housebound and permanent and total disability rating, I should not have to go to another C&P exam because the exam I had July 2012 and the statements from my psychologist indicates that I am housebound and permanent and total, as I pointed out with the evidence I submitted with my notice of disagreement dated 1/22/2013. I hope you understand how chronic my PTSD is and especially how extreme my agoraphobia is by reviewing my medical records. I have not gotten any better in the 10+ years I've had this condition. If anything, some of my symptoms have gotten worse since when my condition started. If it is absolutely necessary then I will go to another C&P exam but I shouldn't have to go through that and be put through that again because my medical evidence stating that I'm housebound and permanently disabled is clearly indicated from my last exam records and from my psychologist. Please look at it closely.

[believe]

Here is the last letter ....

January 24, 2013

This is more informaiton for my notice of disagreement submitted January 22, 2013 for the decision dated January 17th, 2013 and housebound not being granted with an effective date of July 28th 2010.

To reiterate. My effective date for SMC (S) housebound benefits should be July 28th 2010 which is the same as my 100% effective date for my claim for PTSD and agoraphobia. My housebound effective date should be July 28th 2010 because my medical evidence for my PTSD and agoraphobia claim clearly indicates I'm housebound.

After my September decision, I was told I had to file a housebound claim if I wanted that because I did not file for it with my claim for PTSD and agoraphobia. Research tells me otherwise and I have strong medical evidence I should have been granted housebound.

"The VA Adjudication Procedures Manual (M21-1MR) mandates that VA adjudicators consider entitlement to special monthly compensation as an inferred issue. VA rating activities are obligated to consider entitlement to special monthly compensation in all decisions where the medical evidence indicates possible entitlement."

"38 U.S.C. §§ 5110(a), 114(s); 38 C.F.R. § 3.400(o). Accordingly, SMC benefits must be
granted when the veteran becomes eligible without need for a separate claim, any effective date must be based on that point in time when the evidence first supported an award of SMC, which may be well before the veteran raised this issue."

[Philip Rogers]

believe - can you post their decision letter from September 20012, blocking your personal info?? Did the examiner state that your agorophobia was either service connected or secondary to your PTSD?? You can be 100% but unless the agorophobia is SC or secondary to your PTSD, the HB will be denied. Other than that I'd request a DRO hearing. Or you can go to the BVA and most likely be remanded back to the RO in 2 yrs. jmo

pr

[believe]

Here is the decision I got September 2012

Service connection for PTSD and panic disorder with agoraphobia is granted with an evaluation of 100% effective July 28, 2010

[believe]

So I should request a DRO hearing for the decision in September 2012? What do I do about my NOD I sent for the housebound and P&T decision January 2013. I have new strong evidence that I submitted "after" my September 2012 decision stating that I am "permanently" disabled. So do I leave the January NOD alone because I'm also disagreeing with their permanent decision? Not sure what to do.