I Am So Irritated With Ineptness! Update.

[kate7772]

Filed a reconsideration for percentage of disability in my husband's mental health claim. Was awarded 50% and we think it should have been 70 due to the symptoms. In the decision, they listed the symptoms required for the next higher level. My husband has at least five of the seven listed but since the C&P examiner failed to fill out the symptom part of the C&P, the award was based on his opinion which was at the 50% level.

In the reconsideration, we asked for a new C&P due to the incompleteness of the first one. A new one was scheduled but the new examiner instead forwarded it back to the original doctor to complete. When he did complete it by listing symptoms, I swear he just went in and fit the symptoms around his original opinion. He said he reviewed my husband's VA treatment records but that is highly unlikely since those symptoms he missed are all through the records for the past 18 months.

Now, the claim is in pending decision approval and DAV says they are denying an increase due to the symptoms not fitting.

How do you get through to these people something as simple as "do it right?"

I don't want to wait another three years or so for an appeal.

Thanks

Kate

Edited April 10, 2015 by kate7772

[georgiapapa]

Kate,

Email Allison Hickey. Even if you emailed her in the past, do it again. There is no reason you and your husband should have to tolerate this BS. I would even cite her your husbands specifc symptoms which are contained in the 70% box in the diagnostic code for PTSD. Advise her you will fax the records to prove it. You have an incompetent doctor or I should say doctors since the new examiner sent the C & P documents back to the original doctor that screwed it up in the first place.

allison.hickey@va.gov

Good luck and don't give up.

GP

[Berta]

Kate, in Feb 2015 you posted this:

"Yes it was. DAV says it is 80% for kidney and 50 for adjustment disorder. I do feel that the adjustment disorder should have been 70 due to the suicidal ideation. The C&P did not mention it but then again, that C&P did not mention anything because the doctor did not ask about problems, etc. it is all through my husbands VA treatment records though. Could that be considered a CUE?"


Your husband is one of the few (so far) Camp LeJeune service connected contaminated water veterans.

I understood he was still employed...has that changed????

With the 80% for the kidney disease and with 50 for the adjustment disorder, they will probably award him 100%

I guess I am confused as to what you feel they should award him.

"Now, the claim is in pending decision approval and DAV says they are denying an increase due to the symptoms not fitting."

There should be more in the decision than 'symptoms 'not fitting'

[georgiapapa]

Kate,

In my reply to your post, I incorrectly stated PTSD rather than adjustment disorder. Sorry for the error. However, as you know, both are rated using the mental health schedule of ratings in 38 CFR part 4. I would still email Undersecretary Hickey.

GP

[kate7772]

Georgiapapa - I did email her, when I found it was going to the same doctor and she forwarded the email to someone that oversees c&ps but never heard anything from that person, which was strange since before I had heard from the people she contacted. I emailed her again today when DAV told us it was being denied again. She responded but basically to say she would find out why it was adjustment disorder and not Ptsd. I had only mentioned that to her as an example of the ways this examiner has screwed up everything and still they send it back to him.

Berta - my husband is at 90% with 80 kidney disease, 50 adjustment disorder and 10 tinnitus. We were asking for a higher rating on the adjustment disorder because the symptoms are clearly aligned with 70% and included all throughout my husband's VA treatment records. That's why I find it highly unlikely the examiner looked at the records though he said he did. I really believe he simply chose the symptoms that matched with his original opinion so as not to look too bad. Also, he never discussed my husband's symptoms during the exam.

He is no longer employed. His problems became so bad, he could no longer even work the limited hours he had been doing since 2012. We did have the employer fill out the TDIU form today so will file for that but do not want to lose the Earlier date of the original claim.

Edited April 8, 2015 by kate7772

[63SIERRA]

he should be able to easily get the TDUI right now.. I would quit dealing with the VSO.. if he is 80 for his kidney disease he has to be in bad shape, and they must consider that he cant get adequate employment, not just any employment like SS requirements.

These VSOs DO NOT like to ask the VA for TDUI or 100 percent..

[Berta]

I see what you mean now, with the TDIU...

TDIU for the kidney problem and then 60 % or more for an additional independent SC disability ( the MH disability that I believe solely stemmed from his service and is not due to his kidney problem)

would warrant SMC S.

A kidney problem rated that high , in my opinion, also might meet the Housebound criteria,without another additional 60 %.

But one thing about MH ratings......symptoms do not count as much as how the manifestations affect one's ability to sustain and retain substantial employment.

Has he applied for SSDI yet?