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Cherie33

Question

Greetings to all...I have been a disabled vet for 12 years and have recently applied for an increase in my rating. When I submitted my claim info, the VA made an appointment for a C & P Exam. I went to the exam and then about a week later, I received a letter that they proposed to decrease my disability rating from 50% to 30%. They told me to submit additional evidence and that a Physician Statement was the best kind. Well, immediately, I visited my Psych doctor and showed him the letter and he was surprised (because he was the one who suggested that I file a claim for an increased rating). Anyway, he wrote a letter, explaining why he felt as if I should have an increase rating and that he thought that I would probably not be able to work again.

I also, had filed a claim of an increase in my other disability of (IBS) currently rated at 10%. They sent me a letter stating that it would remain the same. Of course I didn't go for that either, so I went to my VA Primary Care doctor, and he too wrote a letter explaining why it should be increased.

Now, my question is what do I do next? The VA said in the first letter that I had 60 days to submit additional evidence (which I have already done, with the doctors letters) They told me that they would began the decrease on the first of Nov., however, i called them this morning, and was told that they are considering the new evidence that I just submitted) I also, asked for a hearing, which they scheduled for Nov. 14) However, I actually requested a hearing before I received the letters from my doctors, and submitted it to the VA) I hope that this is all making sence. I am just worried that they are going to reduce my rating..Can anyone offer some advice?

Thanks,

Cherie

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  • HadIt.com Elder

One week?........Now that is a record. What RO is your claim with?

If your doc's gave a good rationalized opinion then you should be OK, do you have a SO?

Have you applied for IU?

If you have submitted all medical you intend to use , then all you can do now is wait. You also might want to get a copy of your C- file since you have requested a hearing, you want to make sure that it is complete.

Edited by JR Reihs (see edit history)
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One week?........Now that is a record. What RO is your claim with?

If your doc's gave a good rationalized opinion then you should be OK, do you have a SO?

Have you applied for IU?

If you have submitted all medical you intend to use , then all you can do now is wait. You also might want to get a copy of your C- file since you have requested a hearing, you want to make sure that it is complete.

JR, my claim is with St. Petersburg, Fl, and yes, I do have a SO (DAV). I hate to sound ignorant but what is a C-file? Sorry, I'm not that savy with VA terms. How would the hearing help me, anyway?

Cherie

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Dear Veteran

The VA wants to cut you now so you appeal on your time and money. File a NOD and then ask the court for an emergency injuncton to stop the VA until the appeal matter can be decided.

Terry Higgins

Hey Terry,

I did file a NOD, and the VA replied with the NOD was premature, because they were only proposing to decrease my rate. However, I sent them additional evidence (a doctors letter from my Psych doc and Primary care doc). So, now I am waiting..I asked for hearing and for them not to make a decision until I have an opportunity to have a hearing..But, that was before I had any doctors notes to submit..So, I'm not sure if the doctors note would be enough or will I still need to attend the hearing.

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Cherie,

Several of us here also use the St.Pete RO -- it sucks, as far as doing their job properly that is I mean, they don't follow their rules and regulations.

They surely must enjoy watching vets dance to their tune over and over

but this is only my opinion.

If you do have a hearing scheduled for Nov, make sure you attend. Take copies of the most recent and important evidence with you that pertains to the support of granting your benefits. You can leave the copies with the C&P examiner.

You could also print out a copy of the rating schedule that pertains to the

specific rating your conditions fall under and are supported by current evidence.

I don't think VA can reduce your benefits while you have a NOD and/or appeal

pending.

Here's some info. you might want to study. Good luck.

carlie

http://ecfr.gpoaccess.gov/cgi/t/text/text-.../38cfrv1_02.tpl

http://www.warms.vba.va.gov/M21_1MR.html

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  • HadIt.com Elder

Cherie33,

If you requested your hearing within 30 days of the purposed reduction, then VA cannot reduce your rating unitl you've had the hearing, no matter how long it takes to have that hearing.

The VA was correct in not accepting your NOD. A purposal to reduce is just that, a purposal and not an actual rating decision reducing any benefits. If you have already submitted all the medical evidence that you mentioned, then all you have to do is just wait it out. The VA will consider the new evidence you sent them and make another determination shortly.

If the VA still decides to reduce your rating by actually sending a such rating, you still have the oppurtunity to file a NOD within one year of that rating.

Vike 17

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Cherie33

That is a record for speed from the St. Pete RO. What were the reasons for the proposed reduction in rating? I just have never heard of them doing something like that but since I also use the St. Pete RO my ears are pricking up. They never send you notice of a proposed increase. Did they say your symptoms had improved and what objective evdience did they have for that opinion? I agree with others that if you are unemployed to go for IU and never look back. They are sending us all a message. When you are IU and get more than five years under your belt it is much harder to reduce. I think they know where you are going and want to head you off. I think you are part of the tidal wave of disability claims the VA sees coming at them, and that these are the kinds of dirty tricks they will use in the future. Maybe some really sick vets won't be able to muster up the reserves to fight back and they get cut.

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Cherie33

That is a record for speed from the St. Pete RO. What were the reasons for the proposed reduction in rating? I just have never heard of them doing something like that but since I also use the St. Pete RO my ears are pricking up. They never send you notice of a proposed increase. Did they say your symptoms had improved and what objective evdience did they have for that opinion? I agree with others that if you are unemployed to go for IU and never look back. They are sending us all a message. When you are IU and get more than five years under your belt it is much harder to reduce. I think they know where you are going and want to head you off. I think you are part of the tidal wave of disability claims the VA sees coming at them, and that these are the kinds of dirty tricks they will use in the future. Maybe some really sick vets won't be able to muster up the reserves to fight back and they get cut.

Hey John999

Their reason stated that the examiner noted some improvement, basically the examiner asked me was the medicine helping me with my moods and I told him, yes sometimes. However, my Psych doctor told me that he had noticed that the same examiner has tried to do the same thing with another vet. So, he wrote me a letter and basically told the VA, that he was surprised that they proposed the decrease my rating and he felt that I deserved a rating >50%. He also mentioned that he thought that it was unclear how much of this was based on the 8/6 C&P exam in which the examiner seemed to question the veracity of my complaints of psychosis as "atypical". He also noted that he never felt that I malingered or manipulated history, for however atypical my symptoms may be, there will always be patients with atypical presentations.

How would I qualify for IU? What would I need to do? I'm hoping at this point, that they raise my disabiliy to 100% (combined 70% schizoaffective disorder & 30% IBS) this is what I am trying for. My Psych doctor also mentioned in the letter that my diagnosis was geared toward that)

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Cherie- that is excellent medical evidence from your doctor.

If you are not working and this doctor could state that your SC disabilities render you unemployable-

send them the attached TDIU form, Under Remarks-# 25- you can refer them to additional page and tell them of any side affects that your meds have that interfere with working and-if you were ever turned down for Voc Rehab, tell them that too.

It would be great if you could even attach something from your doctor stating that in his opinion,based on his treatment records, etc, your service connected condition renders you unemployable. Maybe what he stated will do it anyhow-

Do I understand you are 50% now for the schizoeffective disorder?

Are you rated yet for the IBS or do you seek the 30% for it?

Here is the TDIU form-when I say send them stuff -I mean COPIES- they like to lose the good stuff.

TDIU_form.pdf

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Cherie33

If you are unable to work due to your service connected disability you fill out the IU form and send it in as soon as possible. You can just write a letter and ask for IU without filing out the form to establish the earliest effective date. You can download the IU for from Hadit.

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Cherie- that is excellent medical evidence from your doctor.

If you are not working and this doctor could state that your SC disabilities render you unemployable-

send them the attached TDIU form, Under Remarks-# 25- you can refer them to additional page and tell them of any side affects that your meds have that interfere with working and-if you were ever turned down for Voc Rehab, tell them that too.

It would be great if you could even attach something from your doctor stating that in his opinion,based on his treatment records, etc, your service connected condition renders you unemployable. Maybe what he stated will do it anyhow-

Do I understand you are 50% now for the schizoeffective disorder?

Are you rated yet for the IBS or do you seek the 30% for it?

Here is the TDIU form-when I say send them stuff -I mean COPIES- they like to lose the good stuff.

Hi Berta,

I am currently 50% Major Depression with Psychotic Features (But doctor stated in letter to VA, that I have developed schizoeffective disorder symptoms, independent of my current disability) And I have 10% IBS (I am also try to get this on increased to 30%. (At first they told me that it would remain the same, but I sent in additional evidence (a letter from my VA Primary Care doctor) that it has worsen.

Cherie

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Cherie33, If you have carried this rating for 5 or more years they can't reduce based on one single examination or report. read 38 C.F.R. 3.3449 (a)

Hey Dorothy,

I did read that some time ago and wondered why they even sent a letter to me stating that. I asked someone from one of those Veteran Service Organizations, and he told me, "Don't you know that those laws are made to protect the VA, and not the VET? I said, how so, it clearly states that if a vet has a certain disability rating for at least 5 years then it can't be changed on the account of one doctors statement. Needless to say, that I didn't call him back for any more advice. I tell, you, I've been a Disabled VET since 1994 and I thought that I was on top of the VA game. It seems that they keep adding rules to their game, that no one else knows about.

Cherie

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"I am currently 50% Major Depression with Psychotic Features (But doctor stated in letter to VA, that I have developed schizoeffective disorder symptoms, independent of my current disability) And I have 10% IBS (I am also try to get this on increased to ...."

Can the doctor fully associate the schizophrenic disorder to the SC depression Cherie-even though he said it is "independent " disability? (for secondary Service connection?)

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Cherie33

If you are unable to work due to your service connected disability you fill out the IU form and send it in as soon as possible. You can just write a letter and ask for IU without filing out the form to establish the earliest effective date. You can download the IU for from Hadit.

John999,

I was wondering...Now at this point I am trying to establish the fact that my disability has worsen and has not gotten better. Eventhough, I am waiting for them to review the newest evidence that I submitted (from my doctors) and I have to appear at a hearing on Nov. 14, I can still file for IU? How would I qualify for that? And one other ignorant question, What exactly is IU (I know what it stands for) but what other benefits are you eligible for once you have an IU rating?

Cherie

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"I am currently 50% Major Depression with Psychotic Features (But doctor stated in letter to VA, that I have developed schizoeffective disorder symptoms, independent of my current disability) And I have 10% IBS (I am also try to get this on increased to ...."

Can the doctor fully associate the schizophrenic disorder to the SC depression Cherie-even though he said it is "independent " disability? (for secondary Service connection?)

Hey Berta,

Forgive me if I don't quite "get it" sometimes...But allow me to quote. The doctor stated "I feel that she is deserving of an increased SC rating >50% as I suspect she has developed a chronic psychotic process independent of her depression, more consistent with schizoaffective disorder, and will probably never be able to work again." Unquote.

So, I'm not sure of your question...What do you gather from what the doctor says?

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Cherie33

IU is individual unemployablility. All it means is you can't work because of your SC. I think the doctor is saying you deserve an increased rating and if you are not working you should file for IU right away.

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Cherrie33,

I echo what has been said, you cannot be reduced on one c/p exam if you have service connection for 5 or more years.

At this point you have done what you need to do to protect your present rating. Go to the review and bring your doctors statements with you just in case the reviewers state they are not in your c/p file. It sounds to me that your doctor has already indicated you cannot work, if this is so get him to put in in writing and file for TDIU. In addition submit a claim for the schizophrenic disorder as secondary to the SC depression, if your doctor stated that the disorder is caused by the depression.

Submit the new claims yesterday (ASAP) because if awarded the awards date will depend on the date you submit the claim.

Hi Rickb54,

If the VA knows this, then why would they even present that proposal (to decrease my rating) to me? Also, please tell me what TDIU stands for and what benefits would I have if awarded?

When submitting a claim for the schizoaffective disorder as secondary, can I use the same doctors letter as a reference to proving my claim?

What will happen to the current claim that I already have pending?

Cherie

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  • HadIt.com Elder

Cherie33,

If you submitt a claim for a schizophrenic disorder secondary to an already service-connected mental disorder (in your case Major Depression), you will not receive a seperate rating for it. The VA will rate the most disabling of the two and 'lump' them together and provide only one rating. So, in essence you don't need to actually file a another claim, which will just bog down your current situation. Just make really sure that the VA is aware of the fact the your Major Depression has progressed to the point that you have developed additional psychotic features.

Vike 17

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Cherie33, The Va also tried to reduce me and take away my A/A. They backed off reducing my 100 percent but, they still want to change me to an Housebound rating. I see clearly through their bull----. They know I can't build upon the HB rating for higher SMC. I have a claim in which entitles me to an "O" rating which automatically qualify for an R1. This is pure intimidation on their part to discourage me. I just want to encourage you to fight as hard as you can and don't depend on your SO.

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  • HadIt.com Elder

Rick,

Yes, VA does rate secondary conditions of orthopedic or neurological etiology, but with mental disorders the law states that the VA can only rate one mental disability. If the veteran has more than one mental disorder that warrants service-connection, the most disabling condition will take precedence and the less disabling disorder will be 'lumped' the more serious condition.

Vike 17

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