ptsd Predetermination For Reduction Saga

[USMC_VET]

So heres the deal.

I was given 50% PTSD and 10% for my back in 2011 wiht a combined of 60%.

My PTSD has gotten worse and I had requested an increase and committed the newbie/didnt research mistake and found out later that htis means they can reduce you, etc.

I had a C&P exam 4 months later after requesting an increase due to a recent move, however when i got there they took me to Video con with a psych doctor. They led me into the mental ward wing, no lights on and had to use a key card to get in and then left me in a darkened room and said to wait and the screen would come on when the doc was there.

I was already on edge with the ambience of the place and i was jsut thinking "Man if i say too much they are going to lock me up in here.". needless to say it was a scary atmosphere. Since my initial claim for PTSD and a reason i never completed my claim in 06' was that i am worried i will end up being labeled mentally defective and not be able to own a firearm or have certain jobs. With the latest administration leak of a posisble executive order its not helping my case to myself to pursue this. i collect firearms as a hobby and love to shoot and hunt and not being able to defend my family as well is another major hold back for me, but i will continue.

the screen came on and he started asking questions. my two major holdbacks were the gun issue as well as the fact i was in the process of getting a clearance. I am worried i will los emy clearance/job and not be able to provide for my family. I put on the everythiings fine face and held back a lot.

This was a major mistake i know. months late ri get a letter form teh VA saying they granted 10% for tinnitis, 0% for headaches and proposed to reduce my 50% PTSD to 30%.

I contacted the VSo listed on my ebenefits which turned out to be in my old state. he said to put in a request for a hearing and to keep benefit level at current level until decision etc.

during the 60 days to give evidence i submitted 2 sworn affidavits that it has not gotten better, but worse as well as a DBQ and findings from a Dr. my friend who has 100% PTSD recommended because she knew the VA system (not sure if i shoudl mention Dr's names here?). She sent me a report and i filed that as well as evidence.

that 60 days ended in march and i have waited and waited. i also have a friend who knows someone in a different regional office who i emailed back and ofrth once a week to check my case. Turns out now that it is stil in limbo because of the request for a hearing and they are now going to issue a letter soon.

She said i can do two things

1) Continue with the plan of a personal hearing which she says is more likely than not to go in my gavor, but there is a small risk that they may not go in my favor and then i will ahve to repay overpayment of benefits from MAY 1 until that date.

2) I can send in a statemend rescinding my request for a hearing and have the proposed reduction processed as normal where this is still the same small risk they will reduce you, but the repayment wouldnt probeably be required since the hold up is in the VA's court not mine, because it was going through process of adjudication and not waiting for a hearing i requested.

Either way i can appeal of course.

My question is what should i do next? I know i made the mistake of churching up my interview for C&P which is dumb and stupid and i wont make the same mistake.

In my statement after the proposed reduction i told them the reasons i held back, i was afraid of losing my job, the environment was scary to me.

I havent been seeing a psychologist at all, which i know is a problem but i have wanted to keep things off book with any treatment for the same job reasons as i stated above.

Should i request to drop the hearing or go to it? if i go to the hearing what do i need to do to make a better case?

should i get a secons IMO on top of the first one? i had gone to a couple appointments with the vet center psychologist, but i stopped going because they started to be very invasive to my privacy like "do you have firearms in the house?" I get why they ask, but that is something i would never do, my ptsd doesnt manifest itself in threatening others, i just like to be alone, i dont talk to my wife, i am distant and all that, which is hurting our marriage.

Anyways any help would be much appreciated. I know i made mistakes and have learned a lot in this reduction process as to how the VA really works and how to play their game but i sitll need more pointers from those that have gone through this

[USMC_VET]

"ASK NOD-

See the attached for a more detailed prognosis on where you are headed. Most VA folks will tell you to roll up the carpet and go home with no fight. Ignore them. If you know you are not "better", then defend it. Any unopposed reduction will soon be met with another one. I've seen that frequently. One thing that will hurt you but you can use is no meds and little interaction with shrinks. It's called avoidance.

I will use the avoidance definition thanks for the help, im sure it will come up.

Ignore the gun issue or it will bite you on the ass. VA can seize on it and try to do the Fiduciary switch on you.

Focus on the security clearance as the "issue". DSM-5_Changes_Sweeton.pdf 1.04MB 0 downloads

Best of luck to you."

As far as "fiduciary switch" what is that?

I wasnt planning on bringing up firearms with the VA i keep those worlds separate! I wanted to let the community here know me better and why i made the ridiculous mistake of holding back and putting on the happy face mask for the C&P exam. Its not 100% the VA's fault for the reduction proposal, i know that ball lies in my court, they dont know past what i tell the examiner and if i hold back how would they know how things really are?

"

-broncovet

Whoa, Hoss!

Katrina Eagle (attorney) has a well written article on reductions which has been apparently taken down. Too bad, too. Its a mistake for you to try to show you meet the 50 percent criteria.

Here is why: The VA needs to show you IMPROVED since your last rating. That 2011 rating, plus any other decisions you had since that "continued" your rating more than a year ago, are FINAL.

The criteria they used to rate you at that time is considered met, and you need not meet it AGAIN. Its res judicata:

Literally "a matter judged", res judicata is the principle that a matter may not, generally, be relitigated once it has been judged on the merits.

You need not meet the criteria AGAIN...you need only show that you did not actually improve.

Unless you discontinued your meds since your last rating continuance for PTSD, and quit treatment, it will be difficult for VA to reduce you.

I saw a counselor for a bit before i left my home for a new job in a new state, never started again when i got to Idaho since the VA hospital was 5 hours away, i moved again and am in the 3rd state since th eoriginal diagnosis in 2011. i went to a vet center counselor for a few sessions, but dropped it because it was a pain and mostly because i kept forgetting appointments and got embarassed and didnt want to go back. I hate being so forgetful over everything. plus the first questions were so intrusive in my opinion "do you have any firearms or sharp knives at your home?" i said no of course, but really who doesnt? do i cut steaks and apples with a spoon? And besides what will that information help with?

Katrina EAgle pointed out this is the number one mistake Vets make at reduction hearings...trying to prove they met the criteria, when that is not in dispute! You need, instead, to show that you did not improve since the last continuance of your PTSD rating.

My want of a IMO of current conditions was not JUST to show that i was not improving, but that i was getting worse. this reductions stemmed from a request for increase. I dont want to defend that what i was and am is still i want to prove and defend that its worse as well as shore up any questions as to the bad C&P, etc. i also thought that it took more than 1 interview to establish an improvement. there is no evidence on teh VA"s part other than the one C&P that shows improvement.

What was your GAF in 2011? What is it now?

No Idea, i dont know if it was tested in 2011

Which, if any, symptoms improved? The burden is on VA to prove your symptoms got better, and you can still argue these are "episodic" improvements. All Vets have "good days" and bad days. So what if you had a good day on your C and p exam?

I was having a bad day actually but i pretended to be ok given the location that freaked me out, sitting in the mental ward wing all lights out in room and hallway. needing a pass from an employee to get in or out. It freaked me out to think maybe ill be stuck here or maybe ill lose my job or both.

In the end, the difference between 60 and 40 percent is about 487 dollars for a single Vet. I cant see the advantage for you "throwing in the towel" admitting defeat, but that you should instead go to the hearing.

You could prepare for a "worst case senario" where your rating is reduced by 487 dollars and you have to pay that back for a few months by simply saving 487 per month you are getting now.

I have savings to cover any loss for the moment so im okay in that aspect

In other words, the VA will give you 487 per month, and, there is a possibility that you could have to pay back the 487 per month. Or, you can throw in the towel, and make it certain you will lose 487 per month. I know which one I would chose, and I have never won a fight with VA by giving up. "

I wont give up, if needs be i will buy a ticket to the appeals train and ride it out. It was a shit interview over video conference

[broncovet]

USMC Vet stated:

No Idea, i dont know if it was tested in 2011 (in answer to what is your GAF question).

This is a great reason you need a hearing. YOu need to get your cfile, because you need to see what the docs all wrote about you. Otherwise, you are firing shots in the dark. You probably dont remember what they wrote in 2011.

I would not only ask for the hearing but I would ask that the hearing come "a couple weeks" AFTER they send you your cfile, which you are requesting NOW. Also, ask for the c and P docs CV and credentials. His credentials are assumed good UNLESS you challenge them. If you dont even know what his credentials are, how can you challenge them??

The VA wants us to be in the dark..we make stupid mistakes then, that they can take advantage of.

So get your cfile, and write down what your GAF was in 2011..what meds you were on, what meds you are on now. Also, look at what your C and P doc said your symptoms were. He probably said you had PTSD..but if you had no symptoms, how did he know you had PTSD?

Remember you can attack the credentials of the C and P examiner. Was he a doc? A P/A? A nurse? Did he have experience with training in PTSD? When?

Attorney Chris Attig explains how you can attack the doc that gives you a bum exam report:

http://www.veteranslawblog.org/c-p-exam-2/

YOu can attack that doc's report as he NEVER SAW YOU, only on video! And, you can say the original C and P doc saw you in person, so he was better equipped to give you a fairer C and P exam! So the "video C and P exam" was less complete than the one you got in person which awarded 50 %.

You can also ask for the psych doc credentials. Where did he graduate college? Did he view your medical records? How did he do that when he never saw you? Did he ask for your ID card? How did he even know if you were the same Veteran whose reports he reviewed? Remember, if their is reasonable doubt the tie goes to the Veteran.

Edited June 3, 2015 by broncovet

[USMC_VET]

"

USMC Vet stated:

No Idea, i dont know if it was tested in 2011 (in answer to what is your GAF question).

This is a great reason you need a hearing. YOu need to get your cfile, because you need to see what the docs all wrote about you. Otherwise, you are firing shots in the dark. You probably dont remember what they wrote in 2011.

I would not only ask for the hearing but I would ask that the hearing come "a couple weeks" AFTER they send you your cfile, which you are requesting NOW. Also, ask for the c and P docs CV and credentials. His credentials are assumed good UNLESS you challenge them. If you dont even know what his credentials are, how can you challenge them??

I have to wait for the letter to come from the VA regarding my requested hearing I will then make sure that the hearing happens after. Or now that i think of it should i send in a statement in support of claim regarding this now.

The VA wants us to be in the dark..we make stupid mistakes then, that they can take advantage of.

So get your cfile, and write down what your GAF was in 2011..what meds you were on, what meds you are on now. Also, look at what your C and P doc said your symptoms were. He probably said you had PTSD..but if you had no symptoms, how did he know you had PTSD?

I have a letter to request my cfile written (used template from http://www.disabledveterans.org/2011/01/14/disabled-veterans-sample-foia-letter/) and will send it certified return requested today.

Remember you can attack the credentials of the C and P examiner. Was he a doc? A P/A? A nurse? Did he have experience with training in PTSD? When?

Attorney Chris Attig explains how you can attack the doc that gives you a bum exam report:

http://www.veteransl...org/c-p-exam-2/

YOu can attack that doc's report as he NEVER SAW YOU, only on video! And, you can say the original C and P doc saw you in person, so he was better equipped to give you a fairer C and P exam! So the "video C and P exam" was less complete than the one you got in person which awarded 50 %.

Interesting thing is both my psych C&P exams were conducted (2011 &2014) via video conference so i cant use that defense.

You can also ask for the psych doc credentials. Where did he graduate college? Did he view your medical records? How did he do that when he never saw you? Did he ask for your ID card? How did he even know if you were the same Veteran whose reports he reviewed? Remember, if their is reasonable doubt the tie goes to the Veteran.

Thank you for giving me more to think about. I had heard you can only get your C-File once and then you ahve to pay so i was going to get it after everythign was settled, but what would that do for me?

Your right there may be some interesting things in there to help me. Like when i got the Notes from the neurologist (who i never saw or met) regarding my headaches when a consult was requested from my primary care provider. She worded it very professional sounding but the amount of times the term "subjective report from veteran" appeared in conjunction with "questions" as to the symptoms i was having left nothing to be figured other than "hes probably full of shit and fishing for pills" although i have repeatedly turned down pain meds. My private physician notes i dug up from before the VA exam are much more professional.

I understand there are scammers out there using the system. I am not look for a handout, i am not lying to my docs. There is nothing wrong with TDUI etc if you really need it, etc. However i am not trying to get that when i dont need it, i can and want to work, although i cant do it at the level i used to or want to. Thats life, but the VA is making it shittier than it needs to be.

"

[USMC_VET]

Another question i have is this.

I requested a new C&P exam along with the hearing, however it doesnt look like that will happen.

I know that the VA even in a reduction hearing has to take into account the evidence at hand and if it points to 70% over my curren 50% (proposed reduction to 30%) they have to grant that if thats what the evidence points to.

Should i just face this reduction hearing to save my 50% for now and then appeal the denial of increase and get a lawyer for that?

It would be around 2 years retro for a difference of combined rating of 80% vs 60% so a total around 10-12k depending. i would think this would be enough for a lawyer to take a case and combine the appeal along with appeal the headaches decided during the same time

[USMC_VET]

Update.

Came home today to find a letter in the mail from va for my hearing. June 5. In two days. In a state I haven't lived in for nearly 3 years......wtf.

This has been a issue since I moved.
My original award was in Alaska. Moved to Idaho but every c&p exam in Idaho kept getting scheduled in Alaska. Finally got them scheduled in Idaho but by then (1.5 yrs later) we were moving again and they had scheduled me after the move date....so finally got here and got my c&p exam right. Submitted info via va forms to ro and on bennies to notify them of my new address. Now....I get this.


I called anchorage va and left message with the guy who wrote me the hearing notification letter. I don't know what is wrong with these people. This just drags things out.

I'm thinking of writing a letter/statement in support etc to ask for the hearing at my local va region and to stay the meeting until I can get my c file plus time to review it.

**Further UPDATE

Got a copy of the most recent DBQ.

The C&P Examiner is a PHD licensed psychologist. However I could not obtain a copy of his CV. From what i googled he does not specialize in PTSD but in....

Attention Deficit Disorder (ADD) / Attention Deficit Hyperactivity Disorder (ADHD) Bipolar Disorder / Manic Depressive Disorder Depression Insomnia Schizophrenia

Sleep Disorders

I Think i might be able to make the slightest of case since he did not review my C-File, my SMR, any docs...none but the "Veterans Health Administration medical records" and VA e-folder

Some of the interesting tidbits

"Vet believes he does
an adequate job at work, although he aspires to do more. He is
sometimes forgetful at work."

I said that i dont think ill get fired, I know i am capable of being at a much higher level and pay scale than i am now and was capable of much much more. I said i am extremely forgetful at work, i forget everything all the time, where i parked the car, to get food at the store, to do work assignments....

"Vet will be social, but tends to be his wife setting up activities.
Prefers to be with just his wife and kids, or gardening, etc. "I never
was much of a social butterfly..." "

I said that if i absolutely have to go out because my wife begs me I will do it for a short time. I said i dont make any effort to see family or friends, my wife has to set up those times and make me go. I said i was never a social butterfly but i use to go out with friends all the time, That i never had 50 friends but i always had a core group of 10ish friends all my life. I now have 2-3 people i talk to occasionally on the phone and none where i live.

"Overall, the vet reported that his PTSD is fairly stable over time.
"Before I was married, kids, had more time to myself. Now, the days
are filled. I readily enjoy spending time with the kids. But the
little time we do have, not much time to be alone with myself, quiet." "

I did not say it was fairly stable, i said that i was doing ok at the time. Maybe im not a doctor but "fairly stable over time" to me means im not normal but there havent been big downs and ups, just a stable 'ok'. which is not what i said.

I did say the whole i dont have time to myself, i do need alone time, thats how i recharge, and i dont get that. part of being a father, however i did say that my ptsd makes me seek solace alone in the woods and if i cant get that on occassion i dont do well. hence another reason im not doing as well anymore.

"MENTAL STATUS EXAMINATION: The veteran demonstrated no impairment of
thought process or communication as well as delusions or hallucinations
during the interview. His eye contact and interaction in the session were
within normal limits. He denied both suicidal or homicidal thoughts, etc.
He endorsed a good history of maintaining minimal personal hygiene and
other basic activities of daily living. He was oriented to person, place,
and time. He denied significant memory loss or impairment, obsessive or
ritualistic behaviors, panic attacks, depression and anxiety, and impaired
impulse control. The rate and flow the veteran's speech was within normal
limits. He endorsed some sleep impairment."

I told him that i have issues with keeping thoughts organized, finishing things i start. I said i have issues with remembering to shower and weat clean clothes and that i binge eat unhealthy food. And memory loss....that is one of my biggest issues. Like i said i forget things all the time. I also said i constantly recheck all the locks in the house, i have alarm systems all over and that i get frequent panic attacks at least once a week if not every day depending on the week. The overeating was what i would call impulse control and i also stutter on occasion and lose track of where i am in the conversation. I said that i am always tired, and i dont sleep but 6 hours a night if that, and when i do sleep i toss and turn and dont get good sleep. if that is "some" then i guess yes he is right.

He did endorse that i am capable of managing financial affairs.

My M_PTSD was a 98 not suggestive of symptomalogy but my PCL_M was suggestive of significant PTSD related symptoms.

I think that my M_PTSD was due to the fact i held back on the questionairre as well.

Truth is i have had suicidal ideation however i would never act on it and i dont want to admit that and end up being committed or lose my job, etc.

I will never admit that to the VA

Edited June 4, 2015 by USMC_VET

[Navy04]

Sorry to hear of your hard times bud. Sorry thing is bud, you either have to be crazy crazy with high % or not so crazy and work. What I am saying is I am bad off, Spent 3 months in mental ward in 2012, wife is POA for payments, and I can not own any weapons. Well I don't care, if it means my family and I get the benefits I deserve, they you have to figure out what is best for you. My bud just retired as an E7 and he did not want 100% Total, so he said enough to get 80%, and still work. Good luck and wish you the best