ptsd Need Advice

[WILL821]

Hello Guys and Gals, So forgive me if I'm posting in the wrong place. Last June I submitted a FDC for 6 different items. Last month it was determined by the VA none of them are service connected. I contacted a VSO and they said the va made a determination from looking at 3 weeks of physical theory records even though I have documented MRIs stating sciatica and two different herniations in my spine. NO CMPs, nothing. They just uped and said none of my stuff was connected. They never had my full service medical records. So I sent in my 300 page record and a current screening for TBI and PTSD, along with a NOD and a new FDC for additional items, to include PTSD and TBI. My question is this, I know I have TBI and they screened me for it a month ago. I have an upcoming neuo-psyc test for it as well. What Im worried about is them saying it was not caused by the service. It happened during my first tour to Iraq in 2004. Not to tell war stories, but I was in Fallujah in Nov of 04 during the major operation. It wasnt like I could stop what I was doing and go to medical. I have CAR because of that operation. Will the CAR and the offensive do anything to help my claim when I explain it to the VA?

The new FDC includes the TBI and PTSD. I was diagnosed and given a PCLM score in the low 50s. The same day I was screened for TBI and the report stated I had a moderate TBI, that was submitted as well. When I sent the new FDC the vso had me fill out some paperwork for the ptsd where I had to list the stressor. The entire two months was a stressor so I just picked one incident and articulated it.

They said there was no current diagnosis for my first fdc...but if they had looked in my record they would have seen everything I claimed was in there. Even my final physical stated all of it. So that tells me the Vso was right and they just gaffed it off because they couldn't get my records. Meaning they never looked at them.

So I guess my question is: would the va make a determination without even looking at my medical records? The one time I called the 800 number, they said they were still sending out letters to gather my records? Then two weeks later they made a decision. I don't even think it was two weeks actually. Maybe one.

[Berta]

"Will the CAR and the offensive do anything to help my claim when I explain it to the VA?"

Absolutely.

"The entire two months was a stressor" I sure bet it was!

" so I just picked one incident and articulated it." It is often the best stressor to use, that is the one most easily proven if they ask for proof.
It might not necessarly by the worse incident. They dont rate as to how bad the stressor was as long as it conforms to time,date, place, mos, etc or to "fear of hostile activity" as with the 2010 new PTSD criteria here in our PTSD forum.

This is the second post I have read this week here ( not to include what I recently went through too, where by the VA made 2 denial decisions that they quickly reversed because I whipped out 38 CFR 4.6 on them)

"So I guess my question is: would the va make a determination without even looking at my medical records?"

Yes if they think they can get away with it.

"The new FDC includes the TBI and PTSD" Good.

They might have committed a CUE ( clear and unmistakable error) in the denial.

Do you have evidence of the TBI as in your SMRs, and if not, it would be in the unit Morning Reports or you could seek a buddy statement.


"They said there was no current diagnosis for my first fdc...but if they had looked in my record they would have seen everything I claimed was in there. Even my final physical stated all of it. So that tells me the Vso was right and they just gaffed it off because they couldn't get my records. Meaning they never looked at them."

Exactly. This is a violation of basic VA 101, 38 CFR.4.6.

They might not have even tried to get your SMRs. I got them on that crap years ago....

Your C file will reveal if they made that attempt.You need a copy of it.

Or they did have them but didnt want to read them.

I got them to reverse 2 denials right away by using this reg against them:

This sounds like my VARO, Buffalo NY....in the past 20 years I have accumulated proof ,in many decisions I received,, that they cannot read.,dont want to read evidence, maybe are ordered not to read evidence, or simply do not understand basic VA case law.

Edited May 14, 2015 by Berta

[rootbeer22]

Berta:

You really amaze me sometimes, how you rapid fire great answers on some of these tough questions and complicated issues like WILL821. My disability claim outcome is close now and I get a little discouraged when I see someone like WILL182 that appears to have a good case but that gets "0" in terms of their service contentions connections? Certainly, I know every case and it's evidence is very unique but these negative trends continues to speak for themselves. I've been concerned about this latest "push" to get the claims backlog down and and the overall affect on Vet's claims being adjudicated right now? Who knows maybe it's nothing? Anyway, I'm glad that this board exists and folks like you who are a wealth of information...I've learning alot from watching your posts....thanks...rootbeer22

[Berta]

Rootbeer none of us know it all and I certainly am still learning all the time...

I sure am concerned like you, that although they say the backlog is pealing down....as someone else said here, Haste can make Waste.

Many of us are hardcore claimants and that alone, after battling the VA, has given us a wealth of knowledge

and unlike many vet reps out there, we think out of the box sometimes.

Will821 has the CAR on his DD 214. Don't they know what that means?

Combat Action! The new PTSD regs were developed for men and women who served in OIF OEF,to make it easier for them to attain PTSD comp.

Yet the VA is victimizing them by their failure to do these claims properly. It is a Disgrace.

And everytime this happens, the backlog increases by more claims that take up the queue for the ones the VA has done right and are out of the appeals process.

Personally I don't think there has been any significant dent in the backlog at all, despite the spin, unless some claims are being stuffed away in filing cabinets with no attention to working on them at all.I made the point when I contacted the Sec and UnderSec that we claimants did not cause the backlog. The RO's did.

When VA finally acknowledged my current issues,after 2 1/2 years ( I really was patient this time... like a dope)

there must have been so much dust on them, that they needed a dust buster to even read my C file number.

Those here like me have good cause when we sound pessimistic...yet .I do see changes but these are changes that should have come in the first place,,long long ago and everything Shinseki tried to do right, ( and he tried his best) involved screw ups by the gate keepers to keep the VA status quo..

[WILL821]

Thank you both for the reply. My concern is they stated one of the reasons as not having a current diagnoses. I did eight years and got out in Nov 2011. My record was over 300 pages, chronic sinusitis, scietica, knee and ankle problems, along with the P/t and MRI that states l4/l5 herniated and bulge, l5/s1 herniated and striking nerve root, scanderlotherpy nerve canal....ect.

I never not once even had a c&p....you would think that if they did look at my record I would at least have a c/p....right? I was even denied tinnitus. I'm just lost...

[Berta]

If I were you I would either file an IRIS complaint ( go to www.va.gov, then to Contact Us button, then to Ask a question.

Tell them what you told us here as to how they ignored your evidence and that it is a violation of 38 CFR.4.6 ( a CUE)

I have always written my IRIS stuff in Wordpad and then copied it onto the VA IRIS form , to keep it short but to the point.

Ask for an email reply. They can make stuff up if they respond by phone.

And if that doesn't seem to help, contact allison.hickey@va.gov (the Under Secretary) or Robert.McDonald@va.gov, the Secretary of the VA.

They are putting FDC claims into the backlog by pulling this crap. FDC was not supposed to be handled this way at all.

[WILL821]

I appreciate the advice. I guess I'm just worried if I have a case to do that. You think I do?