ptsd Pending Decision Phase without a C & P (PTSD)

[Muffin]

I was just wondering if anyone has ever jumped to the pending decision phase without a C & P? I have a rating at 0% for headaches; and 30% for MDD.  I have been actively going to VA clinic here in Georgia for MDD since 2011; and was diagnosed through the VA with PTSD. I originally filed the claim for PTSD in June 2014. I know that I can only be rated for one MH, but do any of you think that with the addition of PTSD and MDD that my rating would increase? The Regional office recently called me to ask more questions about my issues and then she stated that I should have added MST.  She then asked me if I had the address of witnesses etc. so I gave her the information that she requested.  I am really nervous because I noticed that in my VA medical records the GAF score is no longer included and my VA mental notes from my last MH appointment were pretty much on how I was doing for that day. 

[Guest]

VA will still go by the symptoms that you report to your Mental Health Provider and your C & P Examiner.  Yes, it is true that you can only be rated for one (1) mental health disorder But VA will rate you for the highest and the closest rating that shows the symptoms that you are having.

Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. 100%
Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships. 70%
Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships.  50%
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). 30%
Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication. 10%
A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication. 0%

Edited October 15, 2015 by pete992

[Muffin]

Thank you for the quick response and I really appreciate this.  Since my claim is in the pending decision phase should I be concerned, because I have not had a C & P exam? The end is nearing and I would like to be rated fairly based on the criteria above.  How can that be done without a C & P?  Does this mean a decision will be based solely on the last MH appointment that I had?...... or If a decision is a made and I don't agree with the outcome could a CUE be justified?

[USMC_VET]

no not at all. 

I filed a FDC in June.  Had notes from orthopedic surgeons regarding my feet, xrays the whole bit. 

was  in "Gathering evidence" untill July

In July we went to "Pending Decision"

In september we went back to 'Gathering evidence" and a C&P was scheduled for october

Never rely on ebenefits status for anything really.  Its not linear, the status has to do with who has it and where they put it.  It often goes back and forth.

I dont know your case and evidence so its hard to say.  If I were you i would go an get an IME now.  You could find in the next week/months you get scheduled for a C&P. 

Now if they dney you without a C&P that is a great case for appeal.

I would NOD and go for a DRO Review, some say go straight to Form 9 and go to BVA, i guess it depends on your DRO's, etc and how long you want to wait. 

 

Keep us updated.  the VA is not REQUIRED to give youa C&P, however all you can do now is just wait and see

 

[USMC_VET]

[Andyman73]

Muffin,

Welcome to Hadit. 

I don't think anyone mentioned to you yet, but I think, and other's here can verify or vilify me on this, but I think the GAF score is no longer used for your SC rating.  Most likely that is why it's been dropped from your case.

Some Vets here have experienced surprising results on their claims that went to decision with out an exam.  If you've been getting regular treatment long term, through the VA, perhaps they have all the evidence they need to give sound judgment on your claim.  I wish you nothing but success!

Semper Fi.

Andyman

[USMC_VET]

Andy you are right the GAF is no longer considered.