ptsd Help From The Senior Members Please...

[Plinky]

Hello,

I am a long time reader of this forum, first time poster. I filled a claim for PTSD a year ago this month and just saw that today my claim was completed. I was awarded 50% SC. I have not yet received the BBE detailing everything, just saw the basic info on ebenefits.

I plan to file an appeal. My question is this; I have read many times on this forum that if you are receiving SSDI for PTSD then the VA is supposed to acknowlegde that and take that into consideration when determining your disabalilty level. I am currently receiving SSDI soley for PTSD and both the IMO and VA C&P Examiner marked the 70% criteria: Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. I also filed an application for IU with my original claim. I know they lowballed me on purpose so they wouldn't have to grant me the 100%.

Can someone please point me to the regulation that states if you are receiving SSDI then the VA should award 100%?

This will give me some ammo when I file my appeal.

This is my first claim ever so I am trying to do everything right the first time so as not to get caught up in a never ending battle.

Any help would be appreciated.

Carlie and Berta your info on this forum in invalubale. Thanks for all the great advice. It has helped me to keep my sanity over the last year.

[Tbird]

Plinky - I did a search of BVA decisions for the terms SSDI but not unemployability or pension. Click on the link below to view the search results.

Search Results BVA Decisions 2014 SSDI not Unemployability or Pension

Hopefully reading through some of these will give you some answers while you wait for others to chime in.

[Gastone]

Pinky: I'm 70% SC PTSD 2010. I did considerable research on VA PTSD rating after my 2010 C&P. I thought I was a lock for 30 possible 50%. Rating came back 70%. My understanding of VA PTSD rating in regards to SSDI. They look at it but VA has a completely different view of your disability situation. There is no automatic 100%VA rating for PTSD based on SSDI that I have ever come across. Your SSDI is taken into account but isn't the End All regarding your rating.

Did you get a copy of your C&P PTSD DBQ and the related clinician notes? When I discuss PTSD rating increases with my fellow Nam Vets, my posistion is you have to have all the 30 and lion's share of 50 for bump to 50% SC. In your case, same thing, almost all of 30 & 50 and lions share of 70. Are you violent and a threat to others? Road Rage ETC?

The APPEAL Train! Plan to get on-board. Your NOD must be fled within 364 days of your Award Letter date. I would recomend the DRO Review with a request for a personal Hearing. It worked for me this past June, I opted for an "Informal Hearing" and after 35 min, 2010 & 2012 NOD's awarded. The )^/2014 Hearing was from my 1st NOD filed back in 2010.

In the mean time I would recommend you immediately file for VA Vocational Rehabilitation on the E-Ben site. A Denial Letter from the Voc Reh Councilor indicating you are not eligible for reemployment at this time due to your SC conditions, could seal the deal on an IU Award.

At 50% SC you are not scheduler eligible for VA Individual UN-employability, check out the requirements. However, if your PTSD makes it Impossible for you to work at anything that would allow you to earn more than $12,???.00 (2014 US Census Poverty level for 1 person) per year, you could get an Extra-Scheduler IU Award. This would pay you at the 100SC rate. Check with your vso, you can file a claim for anything but I've never been involved with this type of IU claim. I'm not sure if there is a claim specific "Extra-Schedular" form.

How did you "see" that you were awarded 50% SC before receiving the Big Brown envelope? Your VSO Rep call you? When you get your award letter, the rater explains how the decision and disability percentage was determined, what evidence was considered. Compare it to 38 CFR 4. Check out the 'Your rights to appeal or decision section," last few pages. The VA form 4107 addresses filing your timely appeal. However it also covers "see line 5" evidence the VA doesn't already have that may lead to a change in the decision. This evidence is called "New & Material Evidence." No matter what Appeal Track you choose, DRO, DRO with Hearing 2to31/2 Yrs wait, or straight to BVA (4-5 yr wait) your claims file stays at your VARO Rating Department all the way up to approximately 4 months before your BVA hearing, it is then Certified and transferred to the BVA for the scheduled Hearing. Near the very end you will receive a VA "90 day New & Material Evidence Cut Off" letter from your VARO. Prior to the end of the 90 days, any N & M Evidence received by the VA triggers an automatic review of your Denied claim by a Senior Rater or DRO. If an award is not made in your favor, a supplemental Statement of Case is prepared and forwarded to you and your representative. That's why the "90 Day Letter," your appeal is not ready for BVA until all N & M Evidence triggered VARO Reviews have been completed and denial has been continued.

Semper Fi

Gastone

[Philip Rogers]

As I recall (which could also be wrong, w/my memory bumps) the VA is required to completely consider the SSDI award and are required to discuss why they disagree, if they do. There was something, in the regs, that I remember, a few yrs back, that the Secretary (aka the VA) is required to accept the SSDI ruling but I haven't been able to find it.

pr

[Plinky]

Thanks for the replies so far.

Gastone - Yes, I have the results from the C&P exam and I was able to see the 50% SC award in ebenefits under the "My Documents" tab. It doesn't go into detail though which is why I am waiting for the BBE.

As for meeting the criteria for each level I would have to say yes that I believe I meet the criteria for 70% as do the doctors who examined me at the VA as well as my personal psychiatrist. Road rage? check. Even documented in my stressor letter.

Granted I have yet to be hospitalized but I consider that a good thing....Don't think I could handle that.

[Gastone]

PR: All i recall reading is that the Rater must attempt to obtain any and all SSDI records as well as any and all VA Vocational Rehab Records if the Vet indicates either one. My VA Voc Rehab Councilor told me that a rater came down to see my 2011 file, but he was at lunch and the rater never came back. After my 09/2012 IU denial I reapplied to Voc Rehab in order to get the "Currently Denied Voc Rehab services due to SC Conditions" letter. My DRO had it as evidence at my 06/14 hearing. I could have gotten the letter back in 2011 when I dropped out due to SC conditions. It wasn't proffered, I didn't know about it and didn't ask for it. I had to reapply, see a new Voc Rehab councilor to get the letter.

I think SSDI determines that you can't do your old job now and in the future, even if in an unrelated field. The VA PTSD rating is completely different than the SSDI, never checked but I don't think th SSA uses the 38.cfr 4 rating criteria, I'll have to checked that out. VA IU is about if you can be retrained for Gainful Employment, income in excess of the $12,???.00 per year, no matter what your education or experience level is.

Semper Fi

Gastone

[Gastone]

To Whom It May Concern: Just checked out a legal page regarding VA PTSD Ratings Vs SSDI. Readers Digest Version: VA assigns Disability % 10-100% and must be service connected. SSDI. it's all or nothing, no percentages. An interesting note, check out McCarthy Vs Barnhart (9th Cir 2002). Judges order that the SSA must give "Great Weight* to an applicant with a VA SC PTSD Diagnosis and rating. I don't believe it's the other way around. From this article a SSDI award only says you have employment problems from PTSD, no percentages. Please advise if different info available.

Semper Fi

Gastone