ptsd Need Help With Claim..all Info Inside ....

[chrome_305]

My story, Its long but its detailed....

------------------------------------------------------DENIED CLAIM---------------

I am currently receiving the NSC pension I didn't even know anything about it until early 2011 it took me only six month to get the whole process done. Should I file for IU and P&T or one over the other?

At my very first C&P in Dec 2005.I told him about my time in Iraq and the whole nine yards. I was diagnosed with Dysthymic Disorder. I was discharged from the service in Sept 2005. A couple months later I found out my local VA had mental health help and I started seeing a Doc.

Since then I have been in and out of the VA mental center plenty of times. My VA psychiatrist has Baker acted me on four separate occasions since 2009. Currently I am on Depakote 500mg two at night. My VA psychiatrist has put me on many meds. I checked my records a few days ago and my VA doc has written that I had PTSD then a few months and visits later she changed it to Bi-polar disorder.

I have been trying to get a service connection rating above 0% which is what the VA has given me since I was discharged in 2005. Should I open a claim for Bi-polar disorder or try to get the VA to re-rate my Dysthymic disorder? How do I get the VA to acknowledge my mental illness? I don’t understand how I can get NSC pension and treatment/ meds for my disorder but not have them rate my mental illness above zero. I regret not seeing a mental health while I was in service, but I was diagnosed at my C&P within 3-4 months of being discharged you would think the VA could put 2 & 2 together.

Here is pretty much my last decision below(I currently have a SC appeal going for things that are not service connected.) If someone could help me out I would be grateful. I just found this website and it has given me more information than anyone at the VA.

------------------------------------------------------Last Rating Decision---------------

The records reflect that you are veteran of the gulf war era.
Decision
1.) The claim for service connection for dysthymic disorder remains denied because the evidence submitted is not new and material.
2.) Entitlement to service connection for treatment of dysthymic disorder specified under 38 U.S.C 1702 is granted.

Reasons:
1.) Evidence is not new...Rating decisions dated June 13, 2006, Feb 6, 2008, and April 24, 2008, denied service connection and continued the denial of SC as the condition neither occurred in nor was caused by service.
2.) Service connection for dysthymic disorder for the purpose of establishing eligibility to treatment.
Entitlement to service connection for treatment of dysthymic disorder specified under 38 U.S.C 1702 is granted.
A determination of service connection under 38 U.S.C 1702 is for the purpose of providing eligibility for hospital and medical treatment for veterans of gulf war service who have develop a mental disorder during or within two years from the date of separation from such service or within two years of the end of the war period, whichever is earlier.
Treatment reports from Bay Pines VA dated Dec 13 2005 to Aug 20, 2010 were reviewed. Mental disorders examination on May 31 2006 notes an Axis I diagnosis of Dysthymic disorder.
You were discharged from the military on Sept 30 2005. Entitlement to treatment is established because a mental disorder was diagnosed within the required period of time.

Subject to Compensation (1.SC)

• Residual of fracture of the left ring finger with pinning, to include post traumatic arthritis with ankylosis of the distal interphalangel joint (Dominant)

Service Connected, Gulf War, Incurred
0% from 2005

• Chest wall syndrome, claimed as chest pain, tightness and difficulty breathing

Service connected, Gulf War, Incurred

0% from 2005

• Syscosis barbae, claimed as razor bumps of the face

Service connected, Gulf War, Aggravated
0% from 2005

• Combined Evaluation for compensation

0% from 2005
Not service connected/Not subject to compensation (8.NSC Gulf War)
Intermittent Low Back pain
Hearing loss, Left Ear
Tinnitus
Rash on Chest
PTSD/other/unknown-PTSD
Dysthymic Disorder
Treatment Purposes only
Dysthymic Disorder
-Active psychosis/GW mental, SC for treatment Only

-----------------------------------------------------NSC pension---------------

Also to get the NSC pension which I am receiving it says
In addition to meeting minimum service requirements, the Veteran must be:

• Age 65 or older, OR
• Totally and permanently disabled, OR
• A patient in a nursing home receiving skilled nursing care, OR
• Receiving Social Security Disability Insurance, OR
• Receiving Supplemental Security Income

-------------------------------------------- Recent events----------

I went and got some new copies of my records and in my C&P(one & only C&P) notes I found new things. Like it has a diagnosis of Neutropenia. In 2008 I found some hematology report that says...

Tests:
Completed by my VA Physician and the VA Health care system:

• Diagnostic and Clinical Tests: C&P VA/Dec 16, 2005: Neutropenia
• Hematology Report: VA Doctor on or around 09/08, 2012: States the Hematology as persistent leukopenia, now with mild thrombocytopenia.

I was discharged from service in Sept 05 I have a diagnosis for Neutropenia and some other things added on my one and only C&P exam. The report was made based on records from 12/05. The report also says ..."In summary then, the medical evidence supports the current disability claim. The medical evidence supports the ocurrence in military service and the medical evidence supports a nexus between injury and his current disability." this report is signed on 6/06.

-------------------------------------------My Q's----------

What do some you know?

As far as my chances with the VA. I know its aways a long wait but does my case look good?

Also why didnt the VA file a claim for me for most of the conditions I found in my C&P exam like neutropenia?

Can I claim some of the conditions like Neutropenia, thicking of Mitral valve, as secoundary to the chest pain or open new claims since some of those things are on my 1st C&P report from 2005.

--------------

If you need more information please ask. I know its a long read but I hope some people here can help. Those with any experince in this situation

TY

Edited March 14, 2013 by chrome_305

[chrome_305]

Do not file another claim!!! You are already service connect for your condition at 0% because the VA felt that you did not quailify for anything higher. You can only claim one mental health disorder. When you challenged that claim you did not provide any additional information to change their minds. You need to have a private or VA psych dr fill out a DBQ for mental health disorder.

Disability Benefits Qeustinaire

http://benefits.va.gov/TRANSFORMATION/dbqs/ListBySymptom.asp

This the the first thing under the ruling decision on my claim: I was discharged in Sep 05

Reasons:

1.) Evidence is not new...Rating decisions dated June 13, 2006, Feb 6, 2008, and April 24, 2008, denied service connection and continued the denial of SC as the condition neither occurred in nor was caused by service.

There are two different locations in my first C&P exam notes that say the condition started in service. Can the VA just do there own thing and ignore the C&P exam?

To me the VA skipped those parts and based the decision on there own thing. I don't undertstand how that can happen. Atleast it should be service connection but at a low percent. Its just listed as not caused by service when all the laws and rules says it should be.

[Berta]

I admit I am totally baffled by all this.

For one reason ,if a veteran has a psychosis, manifested at least at 10% disabling, during the one year period after their service, the VA can and should SC the condition.

http://www.law.cornell.edu/cfr/text/38/3.309

It is odd to me that the doctor wrote this:

Treatment Purposes only
Dysthymic Disorder
-Active psychosis/GW mental, SC for treatment Only

And the doctor classified this as a psychosis but DTreatment Purposes only
Dysthymic Disorder
-Active psychosis/GW mental, SC for treatment OnlySC “for treatment only.

I guess the VA found no evidence that warranted at least a 10% rating that might have allowed 38 CFR 3.309 to kick in , as a chronic presumptive.

There are too many diagnosis in your records.....

Very odd.

“At my very first C&P in Dec 2005.I told him about my time in Iraq and the whole nine yards. I was diagnosed with Dysthymic Disorder. I was discharged from the service in Sept 2005 “

When did you enlist into the service?

Broncovet is right:

“He said that he is 0% percent.. Its not a question of being service connect, but rather a question of his severity. “

Yes and whether his disbility raised to a compendable level within one year after service (38 CFR 3.309)

Do you receive SSI ? If so what is the SSI diagnosis? (then again the NSC pension would offset the SSI or vice versa)

What were you Baker acted for? Where were you hospitalized due to Baker Act?

Did the VA have those medical records?

There is a lot to being Baker acted......

“I was discharged from service in Sept 05 I have a diagnosis for Neutropenia and some other things added on my one and only C&P exam. The report was made based on records from 12/05. The report also says ..."In summary then, the medical evidence supports the current disability claim. The medical evidence supports the ocurrence in military service and the medical evidence supports a nexus between injury and his current disability." this report is signed on 6/06.”

This can be obviously service connected but did you ever formally claim this?

I dont know if the leukopenia or neutropenia can be rated but maybe the thrombopenia involvement would get it to a ratable level. However since June 2006, did you receive any treatment for this condition?

Something is wrong with all of this...

Either you had evidence in your SMRs and after service medical records they did not consider, or as Dot09 suggested the DBQ , as

you need a concrete diagnosis, or something else is wrong here.

You need to realize this as well.......I don't have the rate charts for SC comp in front of me but, you would have to get a SC rating high enough to make it worth while to NOT be on the pension.

You cant get both and I am only guessing that NSC pension might be about 800 PM???? and that gives you an idea of how high your comp would have to be (per the compensation charts), to have SC ratings even make a difference to you, monetarily.

Edited March 26, 2013 by Berta

[chrome_305]

I admit I am totally baffled by all this.

For one reason ,if a veteran has a psychosis, manifested at least at 10% disabling, during the one year period after their service, the VA can and should SC the condition.

http://www.law.cornell.edu/cfr/text/38/3.309

It is odd to me that the doctor wrote this:

Treatment Purposes only

Dysthymic Disorder

-Active psychosis/GW mental, SC for treatment Only

And the doctor classified this as a psychosis but DTreatment Purposes only

Dysthymic Disorder

-Active psychosis/GW mental, SC for treatment OnlySC “for treatment only.

I guess the VA found no evidence that warranted at least a 10% rating that might have allowed 38 CFR 3.309 to kick in , as a chronic presumptive.

There are too many diagnosis in your records.....

Very odd.

“At my very first C&P in Dec 2005.I told him about my time in Iraq and the whole nine yards. I was diagnosed with Dysthymic Disorder. I was discharged from the service in Sept 2005 “

When did you enlist into the service?

Broncovet is right:

“He said that he is 0% percent.. Its not a question of being service connect, but rather a question of his severity. “

Yes and whether his disbility raised to a compendable level within one year after service (38 CFR 3.309)

Do you receive SSI ? If so what is the SSI diagnosis? (then again the NSC pension would offset the SSI or vice versa)

What were you Baker acted for? Where were you hospitalized due to Baker Act?

Did the VA have those medical records?

There is a lot to being Baker acted......

“I was discharged from service in Sept 05 I have a diagnosis for Neutropenia and some other things added on my one and only C&P exam. The report was made based on records from 12/05. The report also says ..."In summary then, the medical evidence supports the current disability claim. The medical evidence supports the ocurrence in military service and the medical evidence supports a nexus between injury and his current disability." this report is signed on 6/06.”

This can be obviously service connected but did you ever formally claim this?

I dont know if the leukopenia or neutropenia can be rated but maybe the thrombopenia involvement would get it to a ratable level. However since June 2006, did you receive any treatment for this condition?

Something is wrong with all of this...

Either you had evidence in your SMRs and after service medical records they did not consider, or as Dot09 suggested the DBQ , as

you need a concrete diagnosis, or something else is wrong here.

You need to realize this as well.......I don't have the rate charts for SC comp in front of me but, you would have to get a SC rating high enough to make it worth while to NOT be on the pension.

You cant get both and I am only guessing that NSC pension might be about 800 PM???? and that gives you an idea of how high your comp would have to be (per the compensation charts), to have SC ratings even make a difference to you, monetarily.

“At my very first C&P in Dec 2005.I told him about my time in Iraq and the whole nine yards. I was diagnosed with Dysthymic Disorder. I was discharged from the service in Sept 2005 “

Berta: When did you enlist into the service?

Chrome: I enlisted from sept 01-sept 05

Berta: Broncovet is right:

“He said that he is 0% percent.. Its not a question of being service connect, but rather a question of his severity. “

Yes and whether his disbility raised to a compendable level within one year after service (38 CFR 3.309)

Berta: Do you receive SSI ? If so what is the SSI diagnosis? (then again the NSC pension would offset the SSI or vice versa)

Chrome: SSI said that there is a possibility I did not get approved for SSI because I am recieving another thing which I would guess is the pension. So no SSI for me.

Berta: What were you Baker acted for? Where were you hospitalized due to Baker Act?

Chrome: My VA doc baker acted me because I had suicidal feelings almost OD on meds and she thought it would be best for me. It happen more then once in regards to being baker acted. I was hospitalized at VA hospital but

Berta: Did the VA have those medical records?

Chrome: I don't think they had those records at the time of the decision but they had all other evidence and diagnosis.

Berta: “I was discharged from service in Sept 05 I have a diagnosis for Neutropenia and some other things added on my one and only C&P exam. The report was made based on records from 12/05. The report also says ..."In summary then, the medical evidence supports the current disability claim. The medical evidence supports the ocurrence in military service and the medical evidence supports a nexus between injury and his current disability." this report is signed on 6/06.”

Berta: This can be obviously service connected but did you ever formally claim this?

I dont know if the leukopenia or neutropenia can be rated but maybe the thrombopenia involvement would get it to a ratable level. However since June 2006, did you receive any treatment for this condition?

Chrome: This is something that has progress. I first had neutropenia/leukopenia then couple months later which is still inside the one year mark I developed thrombocytopenia. The doctor just tells me to keep following up. If we have to do a bone marrow test we will. I just filed a claim for this since I just found those C&P files. I didn't even know they existed.

Berta:Something is wrong with all of this...

Either you had evidence in your SMRs and after service medical records they did not consider, or as Dot09 suggested the DBQ , as you need a concrete diagnosis, or something else is wrong here.

Chrome: I think they didn't consider a lot of things I also think the VA rep in are area need to do more for the VET's I mean they give no direction or anything. They just submit paper work and that's all. I feel these things should have been handled long ago.

TY for your help...

[JT24usn]

3.309a is covered under diagnostic codes 9200 series. If the veteran had something under that, then presumptive is conceded. Depression does not fall under psychosis and can't be looked at within one year under 3.309(a). This is where 1703 comes in to get the veteran treatment (due to high suicidal rates of gwot veterans) that way they at least get treatment. If he had depression and was diagnosed in service then an exam would probably at least need to be done to link, OR if the veteran sought treatment for being sad in service but no actual diagnosis then at least an iMo or exam probably needed. JMho

[JT24usn]

Considered under 3.309(a)

Schizophrenia and Other Psychotic Disorders

9201 Schizophrenia, disorganized type General Rating Formula

9202 Schizophrenia, catatonic type

9203 Schizophrenia, paranoid type

9204 Schizophrenia, undifferentiated type

9205 Schizophrenia, residual type; other and unspecified types

9208 Delusional disorder

9210 Psychotic disorder, not otherwise specified (atypical psychosis)

9211 Schizoaffective disorder

[jbasser]

You need to do the following: Stop: Take a deep Breath: Gather All records: Fire the DAV: Get an Attorney: Don't just get any attorney. Get Bergmann Moore, Ron Abrams, Doug Rosinski or someone who is an expert in how the VA operates.All these folks are Pro Bono. Getting someone who says they know the VA but actually doesn't would be like getting Sonny Bono.

You need to also get more agressive and be proactive on you claim.

J