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Diagnosis/c&p


carlie

Question

If a vet has already been diagnosed by VA shrinks repeatedly as having PTSD and has been receiving treatment through VA for 8 to 10 years -- will this vet still have to have a C&P exam for PTSD in order to be rated ?

Thanks,

carlie

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Carlie, the importance of a C@P examination is not only to evaluate the evidence, But to analyze the history and make the Opinion. Show a Nexus in service. The Vet will most likely get one.

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It sounds like the diagnosis is there, but if it's not been rated, then th eGAF and other info have not been put together for rating consideration between VA departments. I've not heard of any ratings on PTSD being given without the exam. You are basically being observed and probed during a Comp & Pension exam, then your records reviewed to cooberate this information with your GAF score for them to come up with a rating, typically low-balled the first time around. Make sure if you're talking that the C & P examiner is writing, you may even wish to make a list of everything pertinant before your exam (e.g.; reactions to situations, types of nightmares, alcohol/drug self-medication, suicide thoughts or attempts., etc.). Also make sure you gather every shred of evidence you can of in-service stressors and events, get a copy of your medical records and your comp file from the VA to review as well.

Another tip I would lend is the questions that are asked during their exams. They will try to lad your answers in order to justify the lowest level of compensation. Any question you are not certain of its intent insure you query the examiner as to what htey mean, exactly. If there was ever a time to be laundering what you're going thru, this will be the time.

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  • HadIt.com Elder

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I have spoken with a couple of vets in the last few years that have been in treatment for PTSD for years but never filed a Claim for Comp.! Once they did file, all the evidence was there for a Rating Award. They were NOT sent to a C&P Exam. But this is the exeption, not the norm. A C&P is not required by Law if all the evidence of record establishes a current diagnosis and rating. ~Wings

Edited by Wings (see edit history)
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  • HadIt.com Elder

I was rated initially without a C&P exam, but I think that nowdays even if you have a agent orange presumptive disease you will be sent for a C&P to allow the VA to set an effective date as of the C&P. I was disanosed with hyperglycemia which is another word for DMII. I filed a claim for DMII due to AO. I was not given the diagnosis of DMII until my C&P exam so my effective date is the C&P. This is how the VA fools around with cheating on retro. In my case there was no retro but if I had filed 5 years ago and my effective date of the award was a C&P last month I would have been cheated out of 5 years of retro. The VA is doing this as of now. I think the VA is cheating on a lot of DMII awards by misdiagnosing as Pre-diabetes or hyperglycemia. The VA would say if your fasting glucose is 125 you have pre-diabetes and if you have a level of 126 you have DMII and are entitled to compensation.

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John-I cant agree with you more!

Did you ever get a NSC rating for hyperglycemia in any rating decision prior to the DMII regs?

I would fight that if you did- as this would be the EED under the Nehmer Court Order.If they say the glucose wasn;t high enough -over 126- it could be argued that many VAMCs used to have 110 and over as a high glucose value.That value is on the blood chem records.

As I posted here before NVLSP found that VA was improperly compensating Agent Orange vets to the tune of millions and NVLSP got them their money.

Just like that local vet I helped-they gave him the C & P date for retro-on diabetes- boy did we raise a fuss on that one.He had diabetes so long that he was already blind in one eye from it and had 3 heart stents from the diabetes.

As I recall they awarded him finally back to date of claim-but wanted to pay his lawyers too much.

This was a remand from CAVC back to BVA back to VARO.

The VA wanted to pay his lawyers not only for crappy work at the CAVC but also for a older CAVC claim he had as Pro se.

If you are a Pro Se litigant -they cannot charge any future lawyers for a past court claim.

I was so mad I copied his two dockets off the CAVC site and asked the VA point blank- what work did these lawyers do for him during the first period of time when he was at the CAVC and they had not even represented him?

I am trying to get his $8000 lawyers fees reduced to $4,000. I think their help was worth about $400.00-if that.

It can be done. The VA has a five point criteria for payment to a lawyer who represents a claimant at the CAVC. You can challenge the payment and we sure did.

Edited by Berta (see edit history)
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