ptsd Ptsd Claim Opinion.

[jaszper]

Hello all and thanks in advance for any help. So I'll try and make this as clear and concise as I can. I'm 30% SC already for injuries that happened in the military. I put in my ptsd claim in 2010 and was given a 10 minute c&p that was terrible. I was originally denied for lack of stressor event proof. I put in my NOD and received another letter that said denied for lack of evidence of stressor event. So that's twice I've been denied because of lack of proof the events happened. One of my problems with it is that the reason I'm SC for the 30% is because of 2 separate incidents that happened in the military that caused and then made the PTSD worse. The first incident was in 2001 while in AIT I was walking and hit by a hit and run driver. Multiple injuries from that. 2 that I'm SC for. I then deploy to Iraq in 03 for the initial push. I have multiple incidents from that. The day I'm back from that deployment I end up getting attacked by other soldiers and wind up in the hospital for about 3 weeks. Multiple injuries once again 1 that I'm SC for. Sorry if I'm taking to long to get to the point. So I've been diagnosed by the VA for PTSD since 2004. I have been being treated and medicated for it off and on since that time. Fast forward back to the present and I submitted my form 9 back around the beginning of August of this year. I randomly received a call 3 weeks ago and was told I had a C & P exam for MH. I showed up and was honest and up front. I got a copy of the exam a few days ago and think it was in favor for rating me. If I can figure out how to post it here I will. If anyone needs anymore info about the situation please ask because I'm not sure I explained the situation very well.

My main questions are:

How can the va deny something happened that they SC me for?

Is it possible that the new c&p exam will reverse the decision and get me a rating before I go in front of the board? Timeline for that if possible? I'll post more details if anyone has questions. Thanks in advance.

[carlie]

Due to the following my wag is that SC for PTSD, will be granted.

"a. Stressor #1: -----------"

Does this stressor meet Criterion A (i.e., is it adequate to support

the diagnosis of PTSD)?

[X] Yes [ ] No

Is the stressor related to the Veteran's fear of hostile military or

terrorist activity?

[X] Yes [ ] No"

My wag on evaluation is SC'd 50% to 70%.

jmho

[Berta]

I sure hope so!

But I see 2 things in the exam that concern me.....

Background:
VA exam report of 10/19/10 diagnosed PTSD in relation to an in-service
assault, the occurrence of which has not been conceded by the VA. During

that examination the veteran also mentioned being struck by a vehicle in
the
fall of 2001. He has provided a copy of the accident report from the
Richmond County Sheriff's Department which is of record (tabbed in
c-file).
In his PTSD report of 10/19/10 the VA examiner related veteran's PTSD to
the
unverified in-service event, but did not provide a medical opinion as to
whether any of the veteran's PTSD is or is not "at least as likely as not"

Did you re-open the denied claim or rebutt the denial with the accident report during the appeal period for the denied claim?
Is thes C & P due,in fact to the denied claim and any subsequent evidence you sent to the VA?
Was this report if record when they denied you initially?

This part....
" In his PTSD report of 10/19/10 the VA examiner related veteran's PTSD to
the
unverified in-service event, but did not provide a medical opinion as to
whether any of the veteran's PTSD is or is not "at least as likely as not

(50 percent or greater probability) attributable to the verified
in-service
hit and run vehicle accident. We are thus seeking clarification."

Have you or your vet rep challenged that report as deficient since those key words were not in it regarding an opinion on is or is not"etc......

and
"This is
not the first C&P exam for this veteran--he had a previous C&P
examination, but was denied compensation or pension for PTSD, because the
stressors could not be verified. The veteran was on....etc "

Did the VA reject your buddy statements? If so, did the statements comply with what a buddy statement must contain?

We have info here on Buddy statements available under a search.

It only takes verification of one stressor to succeed in PTSD claims.

Sometimes that one incident might not be as serious as you feel other stressors you experienced might have been, but if it is the easiest to verify, then that is all you need.

Did this new C & P exam occur because of a DRO review?

If this is actually the initially denied PTSD claim, can you scan and post Their Reasons and Bases for the denial here? And the evidence list?

You do have the MH diagnosis but could proof of the stressor, in your opinion, still be a possible issue with the VA?

I guess my concern is,

did the VA have that accident report but still initially deny the claim? That might have been a CUE there if they did have it.
Yet this all seems to stem from that initially filed PTSD claim.



It seems they are going with this specific MVA incident as the stressor.:


"Opinion:
////////
It is at least as likely as not that the veteran's PTSD is related to the
event in the service where he was hit by a car. He also described feeling
scared that he was going to die in Iraq, from gassing threats, and the
fear of chemical weapons. This particular stressor is related to the fear
of hostile military and terrorist acts; the car/mva is not related to the
fear of hostile military and terrorist acts. THere was a third event,
where the veteran was assaulted along with his friend soldier ----------.
There are statements by Mr. --------, and a buddy statement by ----------
, corroborating the assault, thus there is PTSD related to this
incident as well, but it is related to fellow soldiers assaulting him,
and
not d/t hostile military or terrorist acts."

Sorry for my detailed questions. I trust veterans. I just don't trust the VA to handle our evidence in every case, as they should.

The accident report was in your C file, per the C & P doc so I wonder if it was there when they first denied, and if so,then why they denied..but that past C & P exam was deficient anyhow, in my opinion.

Do you have a vet rep helping you?

I do think this C & P should be enough to award you for SC PTSD due to the MVA !

Edited September 29, 2014 by Berta

[jaszper]

I put in a NOD after I got my first denial letter. I don't know when the accident report came into play. I received my latest denial letter which prompted me to file a form 9. Then out of the blue I get a call about a c&p exam. The exam I posted was the results of that. I don't know if a DRO prompted it or not. I recently moved so I lost contact with the VSO I was working with. I'm trying to keep up with all of my letters but it get confusing for me. I will find my latest denial letter and post what they said about my denial in the letter.

One of my questions is if I get the rating will it help me to get MH treatment beyond what I'm getting?

[Berta]

"I recently moved so I lost contact with the VSO I was working with. I'm trying to keep up with all of my letters but it get confusing for me. "

Make sure the VA has your new address!

"One of my questions is if I get the rating will it help me to get MH treatment beyond what I'm getting?"

I am not sure what treatment VA is giving you now. You might want to contact a vet center, if there is one close to where you live.

The C & P said this:

"Outpatient? He stated that he has asked for treatment multiple times:
"The damn doctors--it is so stupid. The only thing they did when I had
episode, was what they always do--they threw more pills at me. I want
treatment. I want to talk about what happened. Presently taking
Celexa; Lamotrogine, and Abilify."

A vet center can be a very good place to talk things out with other vets with PTSD as well as get regular appointments with a VA MH provider.

I was a vet center volunteer with a PTSD group long ago and I sure saw how much understanding that PTSD vets had for each other, and there was a high trust level.

Our VA team leader had PTSD too and we never felt any control by the VA at these PTSD rap sessions.

As much as I gripe about the VA here, they are quite capable of providing excellent PTSD treatment.

I commend your sobriety and relate to how 'pills' are really not the answer, yet often medication can be very effective,too.

I don't know what happened at VA for you to get that newer C & P but it is definitely a good thing, in my opinion!

I think someone finally read the accident report in your C file and VA might have decided to CUE their initial denial

(CUE ...calling a clear and unmistakable error on themselves)

because if they ignored this probative evidence they violated 38 USC 4.6 and that would be a VERY strong argument on appeal. These are our evidentary rights....38 USC 4.1 et al.

I have a claim under violation of that regulation presently ,in an award letter and had succeeded in using it

to get the award in the first place.( Nehmer AO IHD service connected death and 1151 CVA, and SMC CUE, finally adjudicated almost 20 years after my husband died.

Edited September 30, 2014 by Berta

[jaszper]

The VA does have my new address thankfully. I'm hopeful for this claim but I'm trying not to get to excited. I've been burned by them for the last 4 years so I'm a little jaded. My original claim was put in 55 months ago. Will the back pay go back that far?

[Vync]

It could.

Keep in mind the VAMC an the VARO could have different addresses on file. Happened to me.

Good luck.