Jump to content

Ask Your VA   Claims Questions | Read Current Posts 
Read VA Disability Claims Articles
 Search | View All Forums | Donate | Blogs | New Users | Rules 

  • homepage-banner-2024.png

  • donate-be-a-hero.png

  • 0

Predetermination For Reduction Saga

Rate this question


USMC_VET

Question

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

70% - PTSD

->50% - OSA (Secondary to PTSD)

30% - Bilateral Pes Planus w/Plantar Fasciitis

30% - Migraines

10% - Tinnitus

20% - Back

0% - bilateral shin splints

 

 

Link to comment
Share on other sites

  • Answers 20
  • Created
  • Last Reply

Top Posters For This Question

Recommended Posts

  • 0

Navy04 I'm glad you got what you deserve from the va. I'm sorry that you are having to deal with that shit. Glad is no joke. It's nice to have a rating but I would pay money to be "normal" again and I'm sure you feel the same. Thanks for the words of support I will keep plugging along with this...

70% - PTSD

->50% - OSA (Secondary to PTSD)

30% - Bilateral Pes Planus w/Plantar Fasciitis

30% - Migraines

10% - Tinnitus

20% - Back

0% - bilateral shin splints

 

 

Link to comment
Share on other sites

  • 0

I think i may have something, let me know what you think.

In 28 CFR 344(a) it references that "Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction."

However in the Evidence noted for the decision and my proposed reduction they noted the following

NOD 5/19/2014

VCAA Letter 6/6/14

Written Statement 9/19/14

VA examination(s) 12/11/14, 12/15/14. 12/22/14 (These were for all three claims i had)

VAMC treatment records from Alaska VA

VA Treatment records from Idaho VA

However they do not reference the actual DBQ examination that gave me the initial 50% rating? Would this not fall under the "Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction." Since they never even looked at the initial exam to see any difference against the new exam would this not be "less full and complete" and only consulting the rating criteria, etc.?

70% - PTSD

->50% - OSA (Secondary to PTSD)

30% - Bilateral Pes Planus w/Plantar Fasciitis

30% - Migraines

10% - Tinnitus

20% - Back

0% - bilateral shin splints

 

 

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now


  • Tell a friend

    Love HadIt.com’s VA Disability Community Vets helping Vets since 1997? Tell a friend!
  • Recent Achievements

    • RICHKAY earned a badge
      One Month Later
    • pacmanx1 earned a badge
      Great Content
    • czqiang1079 earned a badge
      First Post
    • Vicdamon12 earned a badge
      Week One Done
    • Panther8151 earned a badge
      One Year In
  • Our picks

    • Caluza Triangle defines what is necessary for service connection
      Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL

      This has to be MEDICALLY Documented in your records:

      Current Diagnosis.   (No diagnosis, no Service Connection.)

      In-Service Event or Aggravation.
      Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”
      • 0 replies
    • Do the sct codes help or hurt my disability rating 
    • VA has gotten away with (mis) interpreting their  ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.  

      They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.  

      This is not true, 

      Proof:  

          About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because  when they cant work, they can not keep their home.  I was one of those Veterans who they denied for a bogus reason:  "Its been too long since military service".  This is bogus because its not one of the criteria for service connection, but simply made up by VA.  And, I was a homeless Vet, albeit a short time,  mostly due to the kindness of strangers and friends. 

          Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly.  The VA is broken. 

          A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals.  I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision.  All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did. 

          I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt".   Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day?  Va likes to blame the Veterans, not their system.   
    • Welcome to hadit!  

          There are certain rules about community care reimbursement, and I have no idea if you met them or not.  Try reading this:

      https://www.va.gov/resources/getting-emergency-care-at-non-va-facilities/

         However, (and I have no idea of knowing whether or not you would likely succeed) Im unsure of why you seem to be so adamant against getting an increase in disability compensation.  

         When I buy stuff, say at Kroger, or pay bills, I have never had anyone say, "Wait!  Is this money from disability compensation, or did you earn it working at a regular job?"  Not once.  Thus, if you did get an increase, likely you would have no trouble paying this with the increase compensation.  

          However, there are many false rumors out there that suggest if you apply for an increase, the VA will reduce your benefits instead.  

      That rumor is false but I do hear people tell Veterans that a lot.  There are strict rules VA has to reduce you and, NOT ONE of those rules have anything to do with applying for an increase.  

      Yes, the VA can reduce your benefits, but generally only when your condition has "actually improved" under ordinary conditions of life.  

          Unless you contacted the VA within 72 hours of your medical treatment, you may not be eligible for reimbursement, or at least that is how I read the link, I posted above. Here are SOME of the rules the VA must comply with in order to reduce your compensation benefits:

      https://www.law.cornell.edu/cfr/text/38/3.344

       
    • Good question.   

          Maybe I can clear it up.  

          The spouse is eligible for DIC if you die of a SC condition OR any condition if you are P and T for 10 years or more.  (my paraphrase).  

      More here:

      Source:

      https://www.va.gov/disability/dependency-indemnity-compensation/

      NOTE:   TO PROVE CAUSE OF DEATH WILL LIKELY REQUIRE AN AUTOPSY.  This means if you die of a SC condtion, your spouse would need to do an autopsy to prove cause of death to be from a SC condtiond.    If you were P and T for 10 full years, then the cause of death may not matter so much. 
×
×
  • Create New...

Important Information

Guidelines and Terms of Use