ptsd To Appeal Or Not To Appeal Mdd Denial

[surfhn]

On my VA notes from myhealthevet the Psychologist ammended her conclusions about a month after my C&P exam for PTSD. She noted that I had MDD and that my GAF score was 56. She also stated that my MDD was at least as likely as not contributable to military service. However I was denied the award for compensation and rating. I need some advise on wether or not I have an appeal. I am just confused because of what the doctor noted and the outcome of being denied. I did also have a seperate claim for depression. Any advise would be appreciated.

Thanks!

[surfhn]

OK, how does this sound? I send this to the VA regional office--right? Attention: LSR,

Apparently there has been a clear and unmistakable error that was made by the VA when they recently denied a claim for what I thought was PTSD. The VA examiner noted that the symptoms I have been experiencing were clearly attributable to MDD and not PTSD and that, as the VA Psychologist noted that it is at least as likely as not related to my military service. The VA Psychologist noted this in a, “requested addendum”, to her initial exam. This note, by the Psychologist, is dated 9/17/2013.

There is no cause for the VA to deny my claim for depression when the VA Psychologist attributed it to my military service. This is quite clear in her addendum dated 9/17/2013. I also would like the claim amended to reflect MDD instead of just depression.

Thank you for your immediate attention concerning this matter.

Sincerely,

Edited October 29, 2013 by surfhn

[71M10]

My understanding was that your claim was for PTSD. If they denied for PTSD they have not commited a Clear and Unmistakable Error.

If I were in your situation, I would simply state, I disagree with the decision dated xx/xx/yyy made by ZZZZ regional office. My claim was filed as a PTSD claim. Dr. xxxx, stated during his/her examination(addended 9/17/2013) that I did not have PTSD but MDD and that it was at least as likely as not related to my military service. It is clear that I expressed in my initial communication with the veterans administration that I thought I was suffering from some form of Mental Disorder. An existing mental disorder was identified and determined to be at least as likely as not related to my military service. Please proceed to correct the decision and generate the appropriate disability rating.

You could actually ask for a reconsideration (just remove disagree and ask for a reconsideration). Reconsiderations do not stop the clock on your appeal rights so you would need to be careful to file a disagreement before the year deadline.

A person can at any time ask the VA to fix a clear and unmistakable error (I don't think your situation quite fits that). It is important to note that the VA is only required to respond/address clear and unmistakable error on final decisions.

Edited October 29, 2013 by 71M10

[71M10]

Surfn,

Does the addendum from 9/17/2013, give any indication as to why it was done?

I ask this because generally once the C&P examiner is done they would not come back to that exam or even give it a second thought. I am guessing that:

A clarification was requested by the RVSR or VSR (it would be helpful to know what they wanted clarified)

OR

One of the clinicians you are working with in counseling may have seen the exam, read it and reached out to the examiner for a correction. It may have been a discussion between two collegues (one treating you who thinks you have PTSD and the C&P examiner stating you don't technically have PTSD). The addition of the MDD diagnosis might have been a middle ground (allows both docs to save face and keep the patient in treatment).

As you move forward I think it is important for you to find out WHY the correction was made. It may provide insight important to you winning you claim.

Best regards,

[surfhn]

@71M10

I may have confused everyone, sorry for that. In my decision letter, the VA addresses both the claims that my DAV rep. submitted for PTSD and depression. The claims for PTSD and depression were denied. I was just checking the decision letter and the denial for depression stated that, for one, there was not a diagnoses of depression that,"is at least as likely as not related to military service". This is why I am confused because the Psychologist, in her addendum, stated that it was at least as likely as not related to military service and in the decision letter they stated that there was no diagnoses for depression that is at least as likely related to military service. I believe (although I could be wrong) that they never saw the addendum. So, I should just address a letter to my VARO and show them the notes, (addendum), that the Psychologist made and ask for reconsideration?

To answer your question about why the addendum--I don't know exactly why it was done. I can read in the VA notes from the myhealthevet website that it was a C&P follow up and under Addendum requested is where the Psychologist states that it is at least as likely as not related to military servise. See below. I tried to type it exactly as the Psychologist typed it.

This is what it says:

===============================================================

Date/Time: 17 Sep 2013 @ 1415

Note Title: C&P follow up

Location: My VA hospital

Signed by: The Psychologist who interviewed me

co-signed by: The same Psychologist

Date/Time signed: 17 Sep 2013 @ 1415

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

Local title: c&P Follow up

Standard title: c & P EXAMINATION NOTE

DATE OF NOTE: SEP 17, 2013@14:15:25 ENTRY DATE: SEP 17, 2013@14:15:25

AUTHOR: SAME PSYCH. AS ABOVE EXP COSIGNER: (BLANK)

URGENCY: (BLANK) STATUS: COMPLETED

COMPENSATION AND PENSION EXAMINATION REPORT (FREE TEXT)

=================================================================

ADDENDUM REQUESTED:

This examiner reviewed c-file and examination report of 7/23/13. Veteran has no

pre nor military history of mental health treatment or complaints, worked

successfully in federal position, but has struggled socially historically

since

military experience. Veteran's MDD is at least as likely as not related to

military service. Veteran claims PTSD. Veterans presentation of sxs meet

criteria

with MDD. Veteran has a history of mental health treatment of depression,

multiple failed marriages and poor relationships with adult children. Veterans

occupational history has been fairly stable.

/es/ Psychologist who interviewed me

Psychologist

Signed: 09/17/2013 14:15

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

[71M10]

Agreed it really doesn't indicate what clarification was asked for. I would send the letter (certified mail return receipt requested) stating you disagree with the decision (NOD) and state why. Your DAV rep should be willing to help with that, but they were supposed to review the decision in the first place to prevent simple error. Was the decision issued prior to 9/17/2013?

[Berta]

“ So, I should just address a letter to my VARO and show them the notes, (addendum), that the Psychologist made and ask for reconsideration? “

Yes, if not the CUE I suggested ,that would be a great idea..the reconsideration request ... however, mark your calender so they dont let your NOD timeframe run out by stalling on the recon request.

That is a good point 71M10 but I think a NOD might just add a lot of time to this decision.

My VARO told me years ago that they color code NODs and dont even read them until a year has passed after receipt.

Once VA puts the correct diagnosis down (the MDD) this claim will be awarded based on the C & P exam.

I think this happens more then we know......... A vet knows he/she has MH issues but has to claim something formally and, not being a MH doc themselves, they might put the wrong terminology down.

Sort of like the Gulf War Syndrome glitch.

I sure agree that the DAV could have caught this..... every VARO has DAV reps usually in the same building or close to it.

Your local DAV rep has the ability to contact the DAV who is closest to the VARO and maybe that way it can be fixed.

If a vet claims simply "Gulf War syndrome" and does not explain their documented disabilities,that the Gulf War regs will cover , the VA and the BVA will deny the claim.because there is no diagnosis or rating for Gulf War syndrome. It is the actual illnesses that must be claimed as attributed to GW service.

Edited October 29, 2013 by Berta