ptsd Questions About Award Date

[draggin'swife]

OK, we (me and hubby) put in a legitimate NOD (within the proper time limit) disagreeing with the rating amount for his PTSD- stating that his condition warranted a higher rating than the original rating. At the same time, sent an application for TDIU based on PTSD.

Thankfully, hubby was awarded a PTSD increase and TDIU on the same “award date”. This date was the date the TDIU paperwork was received. Our issue with this is that PTSD was on our original paperwork and was awarded a long time ago. Shouldn’t the award date for the PTSD increase go all the way back to the original date of award on the PTSD? Why in the world was the award date based on the receipt date of the NOD?

Also, the paperwork said that the date of TDIU award was based on the award date of the PTSD increase. (This could be a mistake for them to word it this way LOL) I realize that if the PTSD award date is wrong, this automatically makes the TDIU date wrong as well…but let’s ignore that for a moment. The date that he was unable to work was at least a year before the award date. Shouldn’t the TDIU award date go back to the date of provable unemployability?

We will be making an appeal/NOD (whichever is appropriate here), but not sure what dates to fight for.

Don’t get me wrong we’re thankful for this…but are we getting screwed here?

Draggin’Wife

[jbasser]

You filed a claim for IU which really is not a claim but an ancillary benefit. The date you filed IU was actually treated as a claim for increase.

The filing date was the effective date. That sums it up dont it.

I see this a lot. Vet files a claim gets low balled, NOD's and gets IU awarded. Effective date is date claim was filed because they saw it fit to send for a C and P exam to establish a baseline or time point showing the condition was worsened. That is the old bait and switch. You may need to bring the old legal beagles into the mix.

Does he get SSDI? If so is it based on his service connected issues?

Get an attorney. You are going to need one. I feel bad that you have to deal with Houston or Waco. These places are a major league mess right now.

J

[draggin'swife]

Yes he gets SSDI based on his PTSD. He was awarded SSDI before the NOD and TDIU were filed.

[Berta]

I am a little confused here, like you are...

“Shouldn’t the award date for the PTSD increase go all the way back to the original date of award on the PTSD? “

Yes, but only If the medical evidence of record at that time warranted the increase (and claim was continuously prosecuted after the initial award.

“Why in the world was the award date based on the receipt date of the NOD? “

You sure got me there....

“The date that he was unable to work was at least a year before the award date. Shouldn’t the TDIU award date go back to the date of provable unemployability? “

You stated:

“Yes he gets SSDI based on his PTSD. He was awarded SSDI before the NOD and TDIU were filed. “

It should go this way:

An SSDI award Solely for PTSD in your husband's case, that preceeded the TDIU award, by at least a year SHOULD warrant a possible additional retro payment.

I always use my husband's claim as example.

1983 30% SC PTSD.

1992 SSDI solely for a NSC 1151 stroke EED Aug 1992

1993 ,upon Reconsideration of their award, SSDI awarded

SSDI solely for PTSD, EED Nov 1991.

Rod filed his claim for higher PTSD rating in mid 1992 ,his 1151 claim in 1994, and then the TDIU form in or around fall of 1992.

VA stated his EED of Nov 1991 was the last day he was unemployable solely due to SC PTSD ,per his SSA award,retro to Nov 1991.

(although the SSA only had His VA med recs, the SSA provides,in essense an Independent Medical Opinion for SSDI claims)

With 2 SSA awards it was a little confusing for VA, and they didn't even get his SSA records for many many months. He was dead by time of the 100% P & T for PTSD posthumous decision as they cant award TDIU to a dead veteran.

I supported his claim with evidence in addition to the PTSD SSA award from Voc Rehab, Dept of Labor, etc etc but this is why jbasser asked you if he gets SSDI. Solely for his PTSD.

Was the VA aware of ( it is Question # 18 on the TDIU form)

the fact that he received SSDI Solely for his PTSD during the processing of his claim?

Did they in fact send him 21-22s or any other type of authorization forms in order to get the SSA records?

If VA was aware of those records, did they list the as Evidence in the decision?

If so, what exactly did VA say as to why they did not consider them properly?

If VA did not obtain those records ,with full knowledge from the veteran that they existed and/or if VA did not consider the SSDI records as evidence for a proper EED, the VA has committed a Clear and Unmistakable Error(CUE) under 38 CFR.4.6.

Can you scan and attach (cover identifying personal stuff..name, address. C file number) the Reasons and Bases part of the decision and the Evidence list it contained?

I am baffled as to the NOD date becoming the EED.

I griped a little with my Nehmer NVLSP lawyer over an EED on my AO IHD death claim.

But then I obtained the VA exam that supported the EED the VA used and could understand VA's rationale better. (I had never seen that specific exam in the med recs before)

There could be some good reason for the NOD date being the EED they gave your husband.....but we could help more on that if we can read their actual reasoning in the decision.

Fairly recently here I posted the M21-1MR regs on the EED for TDIU claims, when affected by a prior SSA award solely for SC.

That can be searched for here under our hadit search feature.

Does any vet org hold your husband's POA?

As I mentioned here many times before..... (everything that could go poossibly go wrong with my husband's claims and med care ,did go wrong.As a VA claimant as his widow, I found things even got worse ,but all that gave me a lot of first and experience in how to make sure things Dont go wrong.. My husband always blamed it on the Billboard...)

If you tell VA you get SSDI solely for your SC(s) they need to send you authorizations forms (I think these forms are at the VA web site as well,) sign them ,copy them and send them back to VA with a proof of mailing and address them Attention to: and use the Initials in the initial/numeric code on the letter from VA that requested them.

THEN FOLLOW UP on whether or not VA is making any attempt to get them!

Check directly with the SSA,even if VA says they are attempting to get them....

I already rattled off here the extraordinary broohaha my husband went through on his SSA records.with the VA.

He did have two separate SSA awards and I spelled that all out for them as if they were 10 years old.

But hat wasn't really the problem at all. My husband could have seen his 100% ( or TDIU award) in his lifetime if the VA had not made continual screw ups by failing to even attempt to get those records.

I remain as ticked off on all that today as I was 20 years ago. I hope that BS never happens to any other veteran.

Edited September 3, 2013 by Berta

[broncovet]

The effective date is the later of the date of claim or the "facts found", that is, the date the doc said

were unemployable. There are some key exceptions to this general rule, which may help you win an earlier date:

1. Reopening the claim due to N and M evidence, such as under 38 CFR 3.156.

2. CUE

3. If you applied for benefits within a year of your discharge.

4. If you asked for an increase within a year of your application for benfits.

5. "Notice" violations.

Read this and see if it applies to you:

http://www.purpleheart.org/ServiceProgram/Training2011/W-2%20Common%20VA%20Effective%20Date%20ErrorsL.pdf