ptsd C&p 5-Year Reevaluation?

[MarineLCpl]

Hello gentleman,

I am a new member on the site. Thank you for having me! I'll tell you a little bit about myself..

Background: (Feel free to skip down to present day for the actual concern)

I was discharged from the Marine Corps in 2008, due to mental health issues, including depression, anxiety, and PTSD. I have struggled with these issues ever since, and am still struggling to this very day. Shortly after being discharged, I was contacted by the VA to come in for a C&P exam to determine a course of action. In 2010, I received a rating of 50% for the issues mentioned above. I had a follow-up exam 6-months later, and my rating was increased from 50% to 80%. At the end of 2010, I filed the paperwork for unemployability, and was granted it at the end of that year. It remains current, and I have been in treatment with the VA since then to work on my issues.

In 2011, I applied for the Vocational Rehabilitation program to pursue a 4-year college degree. I was approved, and started attending classes. My first semester went rather well, pulling a B/C average at the end. The second semester, not so well. Ended up having to drop out because my anxiety was so immense. Enrolled to try again the following semester...dropped again...just could handle it, and was released from the program. In 2012, I became very interested in the engineering side of music, and wanted to give it a shot. I liked the fact that it was something I could do on my own, and didn't have to be around lots of others to perform my job. Being alone is when I'm more content.

I was hooked. I again applied for Voc. Rehab, and met with a rep. He was optimistic, which surprised me because of my past history with them, and he said he would run it across his boss and get back with me. He scheduled a meeting with me two weeks later and said that they couldn't approve that particular music program I wanted to pursue, and if that I picked something else (with a little better job security), I would likely be approved. I said no thanks, I'll just have to do it on my own. I think this surprised him, and I don't know if it was just because he could tell I was passionate, but he said he would vouch for me, and to go ahead and start the program. He told me that I would need to prove to him that I was serious, and maintain a 3.0 GPA in order to keep pursuing it. I agreed.

3 years later, I am finally a senior, and have not once dropped below the 3.0 GPA mark. WOW is all I can say to myself. I'm not going to lie, I went through some hard times with my mental health problems during these last 3 years, but I have fought hard, and maintained. I'm serious about doing something with my life and resolving my issues all together. My rep is very happy with me, and always reminds me that I continue to amaze him at holding up my end of the bargain.

This brings me to present day.

The VA has contacted me and scheduled a C&p exam in a couple of weeks. I do realize that it might be routine, but have a slight suspicion that a few VA employees at this facility are out to get me. While my depression has gotten better in recent years due to optimism about being a degree holder, my anxiety level has not changed, which is why I'm hoping that obtaining a college degree will give me that confidence boost I need to survive in the real world and stop getting so worked up about what others think/how they treat me. All I can think about is them taking away my benefits. I can imagine the aftermath, and I know myself pretty well. I would likely go back into depression because funds will start running low, anxiety will increase even more, fear of the future will be at an all-time high, etc.

I have been honest with the VA about my claims, and have sought treatment ever since my discharge. I have heard horror stories that if you tell the VA that you are better (as in my depression being better), they will automatically try and reduce, or take your rating away all together. I have worked so hard, and I'm gearing up for my last year of college, but now I feel as it all might come to a bleeding halt. I have been an American Legion member for 6 years, so I do have them as a point of contact, but I'm not sure if or when I should contact them about the situation.

Any tips, guys?

Thank you for listening, it truly means a lot! And again, thanks for having me on the site.

MarineLCpl

[MarineLCpl]

NOD means notice of disagreement, its a form you file if you diasgree with a VA decision. say you file for PTSD and expect 100% and they give you 70%. you have 1 year to file a notice of disagreement stating you dont agree with their rating, etc. you must present evidence as to why they are wrong or evidence they overlooked, or new evidence to support your claim.

CUE: Clear and Unmistakable error. This is when the va "accidently" overlooks evidence of you claim or mis attributes symptoms. etc. Say for example you claimed PTSD and they deny you and in the decision they only point out the C&P exam as being in the list of evidence that they considered, but you had submitted buddy statements, private physician notes, etc. (and why its important to certify/return receipt all evidence sent) and you can prove you sent it in and they got it, or that it was "lost" in the back of the C-File etc. you can claim a CUE because they didnt consider all the evidence. or say the doctor in the C&P says you have PTSD without a doubt (more likely than not) and the rater say denied because there is no evidence you have it and that it is Service connected. it is a clear and unmistakable error that they made because it was in your exam etc.

Okay, so if they were to lower my rating, and I didn't agree with it, I would fill out the NOD form, and submit it, within one year. Got it.

And as far as CUE's go, I'm not sure how I would proceed with disagreeing when I wasn't there to claim anything. It was just a reevaluation from a previous claim. I believe they routinely do this every so often to see how your condition(s) are, and if they've gotten better or worsened. Do they treat these re-evals like new claims? Do they go through, disect all the information, and make new decisions, or do they just review old exams and compare to new exams, and determine accordingly? The exam notes mention PTSD as a new SC condition, but that has been in my notes beofre, at regular psych visits. It was never addressed then, so will it be addressed now since it's going to the RO? Just a little confused about everything at this point...I will patiently wait..

[USMC_VET]

Okay, so if they were to lower my rating, and I didn't agree with it, I would fill out the NOD form, and submit it, within one year. Got it.

And as far as CUE's go, I'm not sure how I would proceed with disagreeing when I wasn't there to claim anything. It was just a reevaluation from a previous claim. I believe they routinely do this every so often to see how your condition(s) are, and if they've gotten better or worsened. Do they treat these re-evals like new claims? Do they go through, disect all the information, and make new decisions, or do they just review old exams and compare to new exams, and determine accordingly? The exam notes mention PTSD as a new SC condition, but that has been in my notes beofre, at regular psych visits. It was never addressed then, so will it be addressed now since it's going to the RO? Just a little confused about everything at this point...I will patiently wait..

As far as CUE goes I would just wait until your decision comes and then let the experts (berta among others) let you know if there is CUE in there or not.

Re-evals are not new claims they are the same claim and they will either lower, keep same or increase (rare) you current award. You can disagree with them and their decision when re-evaluating your current rating same as a decision with a new claim or a claim for increase.

As far as going through the information...... Technically they are supposed to look at your entire C-File and all the evidence contained in it. all the evidence from your past exams and submitted evidence and then COMPARE that to your current exam and evidence you submitted. If they can show improvement between the initial award and the re-evaluation they have a case for reduction, which is what happened to me.

Yes your exam now shows PTSD and it was noted in past doctors apt's. the past apts were of no concern to Comp and Pension, there is no trigger for a new claim because a VA doctor at a regular apt says you ahve something you have to claim it. However if it is in your exam/apt notes in the past that should help them determine a SC now, etc. However if i were you I would print off of Blue Button ALL those doctors exam notes that mention PTSD and if it is listed in the VA "Problem List" and submit it as evidence now (if your claim is still open for submission of evidence) or hold on to it in case you need to file a NOD. They are supposed to look through your VA medical record, however i never take "supposed to" for granted with the VA

[MarineLCpl]

eBenefits status changed to "Preparing for Notification" today...

This is all happening so fast, and I don't know if that's a good thing or a bad thing..I had my C&P 18 days ago, and it's already at this stage. Eager to see a packet in the mail. When the claim is decided, will I be able to view the determination right there on the eBenefits site, or will I have to wait for the packet to arrive? The process moving along this quickly makes me wonder. Another concern is the address that was on file was wrong. I proceeded to update it to the correct one, and hopefully the change reflects in time before mailing.

Edited July 1, 2015 by MarineLCpl

[USMC_VET]

Contact you VSO and have them make sure hte development/decision letter is sent to the correct address

[MarineLCpl]

Apparently, I just have to hope for the best now....

"Decision Letter Sent"

Edited July 1, 2015 by MarineLCpl

[MarineLCpl]

Their decision:

PTSD w/ Major Depressive - 70%

I will not know if I kept my IU rating until my packet arrives, as I can't find anywhere on eBenefits that shows that information. So, pretty much, they kept me the same, and just combined my mental health symptoms into one rating decison. I don't know if that's how it typically works. So, with my bilateral knee condition, it looks like I will continue an 80% rating.

Should I be happy, or should I appeal?