diabetes Looking Ahead To Possible Ptsd Appeal

[Ruffcreek]

I am a 67 year old VN vet and was rated 50% for PTSD about 8 years ago. Then 6 years ago I asked for an increase which of course resulted in another C & P. At this time I was granted a rating of 100% tempory. A year later I was called in for another C & P for PTSD and remained at 100% tempory. Now five years later I am being called in for another C & P. What has me concerned is what I need to do if they reduce my rating. Would appreciate any advise.

Thanks

P.S. Not that it makes any difference but I am also rated for diabetes, HBP, sleep apnea, and Ischemic Heart disease. If I am reduced on the PTSD I should still be at least 70% and could possibly ask for TDIU. Is that something I could look at?

[71M10]

Since it has been over 5 years they should not be able to reduce you on the results of one doctors examination (if you have a series of treatment notes that indicate sustained improvement under normal conditions, that is a problem). In fact since you are over 55 they shouldn't even be doing a re-exam on you. You might send them a letter reminding them you are over 55 and as such should not need to be re-examined and that they should immediately convert your long standing award to pemanent and total.

Are you currently getting SMCS? if you have a 100% PTSD rating an other ratings, that are a seperate 60% that should qualify you for SMC.

[Ruffcreek]

I must not be getting SMCS since I don't know what it is. So what actually is SMCS?

A VSO I talked to never said anything about the age 55 rule. In fact he said they could bring me in for an exam at any age. Is he incorrect on this and where can I find this rule? Thanks for your reply as I do appreciate it.

[carlie]

I must not be getting SMCS since I don't know what it is. So what actually is SMCS?

A VSO I talked to never said anything about the age 55 rule. In fact he said they could bring me in for an exam at any age. Is he incorrect on this and where can I find this rule? Thanks for your reply as I do appreciate it.

VBA can call any claimant in for an examination at ANYTIME.

It doesn't happen all the time but it surely does happen some of the time

even if over age 55.

http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=9bdb90d88559f16c06b3ff61935bd40f&rgn=div8&view=text&node=38:1.0.1.1.4.1.66.134&idno=38

[free_spirit_etc]

§4.19 Age in service-connected claims.

Age may not be considered as a factor in evaluating service-connected disability; and unemployability, in service-connected claims, associated with advancing age or intercurrent disability, may not be used as a basis for a total disability rating. Age, as such, is a factor only in evaluations of disability not resulting from service, i.e., for the purposes of pension.

[Philip Rogers]

I am a 67 year old VN vet and was rated 50% for PTSD about 8 years ago. Then 6 years ago I asked for an increase which of course resulted in another C & P. At this time I was granted a rating of 100% tempory. A year later I was called in for another C & P for PTSD and remained at 100% tempory. Now five years later I am being called in for another C & P. What has me concerned is what I need to do if they reduce my rating. Would appreciate any advise.

Thanks

P.S. Not that it makes any difference but I am also rated for diabetes, HBP, sleep apnea, and Ischemic Heart disease. If I am reduced on the PTSD I should still be at least 70% and could possibly ask for TDIU. Is that something I could look at?

You should be safe, however, if you are not P&T, now, I would file a claim for it. You should have applied for P&T once you were rated 100% for 5 yrs, as your disability/condition became static after 5 yrs.

As stated you should probably be receiving a Special Monthly Compensation (SMC) "s" award of $336 additional monthly. The "s" award is something you generally don't need to apply for but they could have missed doing it. You do need a rating of 100% + 60% additional. If you have diabetes, you could also have erectile dysfunction (ED), which pays an additional $100 monthly.

Since you were rated at 50% for PTSD originally and 2 yrs later increased to 100%, you might want to pursue a claim for an EED. I could probably be pursued as a CUE. They originally awarded me 30% for PTSD and even tho it took me 10 yrs, I won 100% back to my original claim date. You have a better chance of winning that than you do any lottery and it could be worth $30k-$36k retro.

Also did they mention "A&A or Housebound" in your original 100% award?? They were required to discuss that, at that time. Could be an open claim?

In the event they attempt a reduction you should post that question then.

pr

Edited September 21, 2013 by Philip Rogers

[Philip Rogers]

§4.19 Age in service-connected claims.

Age may not be considered as a factor in evaluating service-connected disability; and unemployability, in service-connected claims, associated with advancing age or intercurrent disability, may not be used as a basis for a total disability rating. Age, as such, is a factor only in evaluations of disability not resulting from service, i.e., for the purposes of pension.

free spirit - FYI - 4.19 has nothing to do w/the 55yo aspect in the application of P&T. (If I interpreted your post correctly)

pr