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Cavman
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I have filed my NOD today. Got rating last week of 50% for ptsd. All my diagnosis at c & p matched a 70% rating. Diagnosed serious impairment to social/employment funtion, mood disorders, suicidal ideation, two ph`s, combat infantry badge etc., unemployed 2 years & gaf of 48. In my denial I explained why none of the diagnosis matched 50% and informed them of being on meds daily so I can`t even drive. Informed them of my doctor relocated and started new treatment plan with new doc this week and a letter of diagnosis would follow soon. My wife also inserted a great letter describing my ptsd severity. By the way they sent an application for IU with my award letter last week. I also ask for a DRO review.I know you can never tell about the VA, but please just give me your ballpark guess as to answer. Also, how long do you think it will take and did I do things right or wrong?

Cavman

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Caveman, The lowballed your rating in order not to give you IU. File the NOD and get to to the BVA or you are in for a 4 year wait. The DRO process is an utter Joke. It is another delay tatic used by the VARO.

The do allow some to pass to make it look effective but in most cases it is like pulling teeth with the same old denials than waiting anoter 2 years for the BVA.

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  • HadIt.com Elder

Cavman,

Your Two Ph's and Combat infantrymans Badge doesn't have anything to do with your evaluation, they just verify your stressor. Your symptoms may have been borderline between 50% and 70% and the rating specialist had to make a judgment call. They didn't intentiionally low-ball your claim so they woldn't have to pay you IU. The reason why I say this is both 50% and 70% require occupational impairment. I suspect your mood disorders could be taken something along the lines of the Flattened effect, I don't know. Suicidal Ideations do fall in the 70% criteria. Do you see where I'm coming from? You didn't post the entire C&P exam evaluation, so I can't say for sure that the VA dropped the ball.

The DRO, in my opinion, is the best route to take. You can also request a hearing with that DRO to present your arguments. I suggest you do this. If the actual writeup from the C&P exam conicides with the 70% criteria, then you'll receive your just rating.

I do find it kind of odd that they sent the IU form with their decision of 50%. Do you have any other service-connected disabilities that affect you ability to work?

Vike 17

Edited by Vike17
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Diagnosed serious impairment to social/employment funtion.

With a GAF of 48, It should at the least be a 70 percent rating wnd that statement alone at the top makes the Vet Qualify for IU.

Observation: Claim lowered to avoid IU issue.

I hate to disagree, Terry, I respect your opinions and I am grateful to you. But personally for me, That is the picture presented by the VA on this issue.

It happens all of the time.

Cavman, do you have a Veterans Service Rep?

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Diagnosed serious impairment to social/employment funtion.

With a GAF of 48, It should at the least be a 70 percent rating wnd that statement alone at the top makes the Vet Qualify for IU.

Observation: Claim lowered to avoid IU issue.

I hate to disagree, Terry, I respect your opinions and I am grateful to you. But personally for me, That is the picture presented by the VA on this issue.

It happens all of the time.

Cavman, do you have a Veterans Service Rep?

Vike:

I was denied AO with stage 4 cancer in the right tonsil that has spread to the lymph nodes. As for the PTSD there was lots more to the diagnosis. When I got my c & p the doc wouldn`t let me talk about stressors. Said he had read the 3 pages I sent and would not put me through the pain of discussing them. I think all I need is a letter from my current doc stating I`m unemployable due to PTSD. Is there a posasibility of getting 70% w/iu from what I sent today?

I am recently granted ssd for 3 herniated disc. That should have no bearing on my VA claim should it. I have also this week filed for tinnitus, insomnia and gerd/barrets. The gerd and insomnia as secondary to PTSD. Any thoughts? Thanks for taking time on my issues.

Cavman

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jstacy:

I have a service rep and he does nothing. I have made up my mind to handle things on my own since reading this site for weeks.

Cavman

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  • HadIt.com Elder

A GAF score alone does not warrant the disability rating. The GAF must coincide with the complete evalation.

For example, let's say a veteran has a GAF of 48 with flattened effect, impairment of long and short term memory, mood and motivation problems, difficulty in estblishing and mainiting work and social relationships, and severe occupational impairment. All of the symtpoms except for the last reflect a 50% rating. So, therefore, the evaluation should probably be a 50%, as the entire write-up is more consistant with that evaluation.

Granted, in some cases it is borderline and becomes a judgmental call on the rates part. If the rater uses bad judgment, then the claimant has the opurtunity to appeal that decision. It makes no difference to the RVSR whether the there is an issue of IU. All they are trying to do is reach a correct decision and make thier daily quotas at the same time. The amount of money involved in a claim has no affect on the outcome of a claim.

Cavman,

Sounds like the C&P doctor was trying to be compationate.

"Is there a posasibility of getting 70% w/iu from what I sent today?" Yes, although if you're unemployable due to a mental condition, then 100% would be the correct evalution.

Your back problems, if they do not contribute to you being unable to work, has no affect on the VA's decision for IU.

You may need an IMO for your cancer to be awarded service-connection. I'm not really familiar with AO claims and their regulations.

Vike 17

Edited by Vike17
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Vike:

I do have a disability for my back and not being able to work a physical job. I don`t believe that is to say I might never be able to work again. The PTSD will never allow me to work and stopped me from working completely in 2003, 2 years before I was given ssd disability.

Cavman

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As my prior reply indicated-

and I think you were incountry Vietnam vet?

If you have an STS cancer on the AO STS list it should be service connected to Agent Orange-

NVLSP and the VA in 38 CFR and M21-1 has a complete list of STS (Soft Tissue Sarcomas caused by Agent

Orange.)

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  • HadIt.com Elder

I agree with Vike 17 on using a DRO with a Hearing to get this straightened out. I also think that you should take someone close to you to explain the difference in you before and after service. I think that you have a winner so please don't give up.

Even though you want to drop your SO I think you should keep them as they will send a seasoned SO at the VARO level into your Hearing and even if you conduct most of the Hearing yourself they will lay the groundwork or frame your claim and also provide imput behind the scenes. Most of the Hearing SO's are good at what they do.

Good Luck

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I agree with Vike 17 on using a DRO with a Hearing to get this straightened out. I also think that you should take someone close to you to explain the difference in you before and after service. I think that you have a winner so please don't give up.

Even though you want to drop your SO I think you should keep them as they will send a seasoned SO at the VARO level into your Hearing and even if you conduct most of the Hearing yourself they will lay the groundwork or frame your claim and also provide imput behind the scenes. Most of the Hearing SO's are good at what they do.

Good Luck

Berta:

My cancer was denied because they say tonsil cancer is not on the list and lymph nodes are, but my cancer in the nodes matastized there from the tonsil.

Cavman

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No- tonsil cancer is not on the "list" they are looking at.

There are about 35 types of STS cancers that VA will SC due to agent orange-

A brief search I did on tonsil cancers revealed that many are adendocarcinomas and also soft tissue type of sarcomas. If your cancer is of those or the 33 other types , it is an Agent Orange Cancer and years ago I typed the whole list here.

It possibly isnt but I bet that the VA did not adequately determine the medical type of cancer you have and it could- based on the search I did -be of a soft tissue sarcoma type.

Your medical records will rveal what type of cancer you have as to the medical terms that could be well within the STS Agent Orange list that I published here and gave links to many times.

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This shows you what I mean Cavman

Renal cell carcinoma is NOT on the "list" the VA looks at.

The veteran's exposure to AO and that adencarcinoma are on the 35 STS conditions that the VA fails to address.

http://www.va.gov/vetapp05/files2/0509244.txt

"CONCLUSIONS OF LAW

1. Renal cell carcinoma, as a residual of Agent Orange

exposure, was incurred in service. 38 U.S.C.A. §§ 1110,

1116, 5100, 5103, 5103A, 5107 (West 2002); 38 C.F.R.

§§ 3.102, 3.303 (2004).

2. An effective date earlier than February 28, 2000 for the

grant of service connection for bilateral hearing loss is not

warranted. 38 U.S.C.A. §§ 5100, 5108, 5110, 7104 (West

2002); 38 C.F.R. §§ 3.156, 3.400, 20.1104 (2004). "

That decision might contain this long list of STS cancers.

These claims involve a thourough review of the medical records to see if the cancer is of an STS type.

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  • HadIt.com Elder

Cavman

The VA is giving their opinion of how your cancer spread to the lymph nodes, but they are trying to protect their asses and deny compensation. That is a medical opinion that could be contested I think. Then you have the benefit of the doubt if your doc says the reverse.

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Terry / Rick your both right. It depends on the DRO reviewer. If you get a good one then OK. There are good ones and there are bad ones. I think personally that a DRO reviewer will side with the Service Center manager. The manager is usually the one who makes the final decision at the RO level. Now for example, If I were a DRO reviewer and I have a disagreement with Terry who is a Service Center manager, Then I am going to side with Terry because terry is the one who does my performance evaluation and a good evaluation gets bonuses as a federal employee.

That is the absolute truth.

Edited by jstacy
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  • HadIt.com Elder

When you opt for a DRO Hearing don't just wait for the DRO to decide on you original case. Go out and get more evidence so the DRO has more to consider. Preponderance of evidence is what wins claims. Arguments don't get it on fine points of VA law. It is just too risky. Things like Benefit of Doubt are fine but you don't want doubt. You want a claim surrounded by evidence.

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