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Senseless Denial And Forced To Use An Attorney ! Unbelievable. !

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DocNyger

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Hello fellow vets, I hope all is well and still in the fight. I am new to the site and welcome any and all comments please... I served for 12 years , I've been involved in 3 wars. I separated in August 2003. In March 2005 I filled a claim for 4 contentions. I finally heard about my denial in Nov 2008. The reasoning that VA stated my denials were that even though the QTC doctors documented favorable statements , he didn't state it was from the military. ( I read the exact notes and he did state back issues, knee issues, hypertension, and depression were from my time in the military ). I also stated the locations on my original claims and sent in multiples documentation via hand delivery to my Regional office, faxing my VSO, and certified mail with Return Receipt. In the denial section the Va stated that there was nothing in my medical records. I filled a NOD in Feb 2009 and to date that appeal is still on phase 1...:(. I started to wonder if it's just me or does the Va really denies veterans for no reason..) So I'm waiting !!!!!

In Mar 2011 I filed for PTSD , and PFB (shaving). I've submitted documentation for both the same vehicles that I did before. I received countless messages from VA stating they need sudden information... The same info I sent.... So I called my VSO again, met with her and gave the same copies I sent in, she supposedly walked it up and personally put it in my C -file. Well later I finally got scheduled for a c and p for PTSD. Nothing for PFB. My initial exam was by a mental health doctor at the Va who verbally told my the she was new to the field and after the exam was over, she diagnosed me with major depression and hypertension, she stated that there were multiple symptom for ptsd but unsure if they meet criteria 1 for PTSD and referred me to a Va contracted mental doctor. My treatment started in the beginning of 2012. During his ignition evaluation, he diagnoses me with probable ptsd. He explained to me why, because he just met me and wanted to spend time with me. Well on Apr 25 2013 I was diagnoses with PTSD have severe symptoms. Now all my records were sent to Va and I once again hand delivered them and got the regional acceptance stamp. In the end of October I received a letter stating that the Va wanted me to go to another c and p for PTSD. I called my VSO and explained what was going on and she just stated " I guess you need to be there" ... Why do I have to go through four different evaluations.!!! I truly thought this was crazy. Well I reported to the c and p examination and I experience a very rude ,biased, and incompetent person I have ever dealt with in my 41 years of living. He asked me two question. Do I drink and how often? And how much do I spend on alcohol a month. That's it !!!! Nothing about PTSD symptoms or nothing. I filled out a form asking what are my symptoms which I stated everything from my treatment records. This guy didn't put anything that I verbally stated or written. He had this ( what ever attitude). Not even 10 min later he stated it's done. You probably won't get it... And left the room.

Well I finally left 5 minutes later when he didn't returned, later in Nov 2013 I received a denial letter stating I was denied because I don't have a current diagnosis of PTSD, even though my treatment notes states probable ptsd the recent ptsd exam did not diagnosis me with PTSD. I was floored !!! I ordered I copy of the exam to find out that the examiner diagnosis me with substance abuse... What !!! No one even looked at my records. I went to my regional office again and spoke to another VSO. I showed him the diagnosis from the contracted mental doctor for PTSD back in April and he supposedly walked it up to the raters. He came back and told me that they said there wasn't a signature from the doctor. I pointed out the electronically signature that many doctor uses, then the VSO stated that it does stated that it's a diagnosis, I stated and showed him in the right corner where it states Confirmed Diagnosis ptsd 309. Etc and severity of symptoms., then I was told that the raters said that they would challenge the diagnosis... At that point I said I'll get an attorney because this is not right and the VSO stated " why would you want to do that, they will take all your money" .. Of course I left and found a good attorney who took my case and was shocked how the Va handle my case. The attorney stated that the Va is famous for creating bad evidence to out way the good .. Is that true? What do you think about my case? I'm sorry for the long message .. Just need to vent and my wife is getting tired of the nightmares, isolation, and me talking about it... Thank all of you in advance for your comments and advice !!!

Edited by DocNyger
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  • HadIt.com Elder

You got your lawyer so stick with him/her. Getting a lawyer does not mean you will win, but it does usually give you a better chance especially if you have to appeal because a good lawyer is always thinking ahead to appeals. I went to a Vet Center where the bona fide VA counselor DX'ed me with severe PTSD. However, the VA rated me 70% TDIU for schizophrenia. I did not have a lawyer back in those days .........2002. If a vet has a 70% rating and can show by being on SSDI or by evidence of Rehabilitation Counselor that he can't work then TDIU is pretty much in the bag. An IME from a doctor/specialist who says you cannot work is also a big help and worth the money. If you are rated 70% for PTSD by the VA and you have an IME psychiatrist that says you cannot work then you are there.

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In a somewhat similar situation, my husband was denied TDIU based upon C&P examiner opinion that he could do sedentary work. He was in an electric wheelchair provided by VA and he worked as a VSO for a State Veteran Affairs Office. He had to travel to different locations and was on pain medication so how could he drive? Would you want someone working on your claim that is using high dosage of pain meds? He couldn't/wouldn't take the chance that he could make a mistake either because of the meds or not take meds and be in so much pain he couldn't concentrate. His examiner was not a doctor but a APRN. The DRO took her opinion over his physician statement because he failed to read the letterhead that she was a VA doctor and assumed she was a private physician.

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I use to think that if you are already receiving SSDI and rated at 90% that it would be a slam dunk as well. I have only been separated less than a year from the military and I was awarded 90% the fist time around, so I submitted a claim for TDUI. They increased three conditions which put me at 93.56% rounded down to 90 which is what I currently have. The other three condition such as Tbi(headaches), PTSD, and Prostatitis were all deferred as of now. I am currently at 70% PTSD, 10% for headaches, and 20% for prostatitis. It was very confusing because the claim showed complete online but when I called the 800 number it was showing Gathering of Evidence on their end. All of a sudden they are waiting on items from the VAMC in which they have already received my medical records. I got diagnosed with sleep apnea in October of this year but I am waiting to submit a claim because I don't want it to slow my current claim down. I'm just waiting to see what happens next with this frustrating system we are all a part of. Hopefully everyone get what they deserve. Good Luck.

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