ptsd Advice needed

[manni]

I went to C&P exam for my IU, before submitting my claim for IU I was rated 50% PTSD, 50% vision, 30% Migraine and 10%TBI. I had my first C&P for Migraine which lasted 15-20 minutes, and then I had C&P exam for PTSD which took about one hour, 15 minutes she was on her phone talking to one of her patients and then she spend about 20 minutes trying to find my military records on her computer. Then she asked me 3 or 4 times about driving and I told her I don't drive anymore. Of course she didn't mention that on her report. Her other question was when I started service and I gave her my DD214. I also gave her a letter from VOC rehab which says I don't qualify for VOC Rehab because my health problems are too severe and again she didn't mention that. I gave her a DBQ from my neurologist which says I can't work but again she didn't mention anything about it, she just mentioned the medication that I'm taking and then wrote TBI has no effect on my social and occuptional  life.
For PTSD she mentioned the following:

OCCUPATIONAL AND SOCIAL IMPAIRMENT DUE TO MILD OR TRANSIENT SYMPTOMS WHICH DECREASE WORK EFFICIENCY AND ABILITY TO PERFORMOCCUPATIONAL TASKS ONLY DURING PERIODS OF SIGNIFICANT STRESS, OR SYMPTOMS CONTROLLED BY MEDICATION

Of course she didn't mention what every Psychiatrist and Psychogists that I visited the last 3 years wrote about my PTSD (severe PTSD).
I still have vision C&P exam but I don't think this will go well too.
Anyway, from what I red I think my PTSD rating will go down from 50% to 10%, I know some will say C&P is just a part of the claim and it doesn't have total effect on rating, that is WRONG C&P decides what rating you will get and the rater depends totally on what is mentioned in the C&P exam.
My question is this, if I get a PTSD DBQ from outside the VA hospital (since no Psychiatrist in the VA will fill one) will that have any effect on my claim or it is too late now?
Will DBQ filled out by a Psychologist have the same as one filled by Psychiatrist?
Is there anything I can do to help my claim?
Any advice will be highly appreciated

[flores97]

Manni, in this situation I would have your wife drive you to the RO, and when you get there tell them you have N&M evidence to give to the rater. I dont know if its feasible for you to do this, but i highly recommend going into the RO physically. Maybe Asknod or Broncovet could give their opinion as well, but you dont want them to lower your rating. Also CHALLENGE the incompetent exam asap. Look up JUNK SCIENCE INVADES VA LIKE ANTS AT A PICNIC(Chris Attics website), it will tell you EXACTLY how to challenge that exam. JMO, and Good Luck!!

[broncovet]

I agree with most of what has been said, but there are a couple things:

1. You dont need to try to show you currently meet the 50% criteria to prevent a reduction.  Instead, the VA has to show you " actually improved, under ordinary conditions of life", in order to reduce you.  This assumes you do not have a "temporary" rating, in which case it would not apply.  If you are permanent or over 5 years, they have to show you actually improved to reduce you.    The IMO/IME sounds good, but I dont think you need that to prevent a reduction.  

3.344 Stabilization of disability evaluations.

(a) Examination reports indicating improvement. Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and Department of Veterans Affairs regulations governing disability compensation and pension. It is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history. This applies to treatment of intercurrent diseases and exacerbations, including hospital reports, bedside examinations, examinations by designated physicians, and examinations in the absence of, or without taking full advantage of, laboratory facilities and the cooperation of specialists in related lines. Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction. Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psychotic reaction, epilepsy, psychoneurotic reaction, arteriosclerotic heart disease, bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest. Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life. When syphilis of the central nervous system or alcoholic deterioration is diagnosed following a long prior history of psychosis, psychoneurosis, epilepsy, or the like, it is rarely possible to exclude persistence, in masked form, of the preceding innocently acquired manifestations. Rating boards encountering a change of diagnosis will exercise caution in the determination as to whether a change in diagnosis represents no more than a progression of an earlier diagnosis, an error in prior diagnosis or possibly a disease entity independent of the service-connected disability. When the new diagnosis reflects mental deficiency or personality disorder only, the possibility of only temporary remission of a super-imposed psychiatric disease will be borne in mind.

(b) Doubtful cases. If doubt remains, after according due consideration to all the evidence developed by the several items discussed in paragraph (a) of this section, the rating agency will continue the rating in effect, citing the former diagnosis with the new diagnosis in parentheses, and following the appropriate code there will be added the reference “Rating continued pending reexamination ___ months from this date, §3.344.” The rating agency will determine on the basis of the facts in each individual case whether 18, 24 or 30 months will be allowed to elapse before the reexamination will be made.

(c) Disabilities which are likely to improve. The provisions of paragraphs (a) and (b) of this section apply to ratings which have continued for long periods at the same level (5 years or more). They do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating.

 

2.    In short, you are unlikely to be reduced ununless you are working, because "actual improvement under ordinary conditions of life" means while you are working. .  It sounds like you have been listening to a VSO who told you, "Dont apply for an increase, you will be reduced instead."  Mostly that is pure balderdash.  If the VA can reduce you, they will, regardless of whether or not you apply for an increase.  

3.  Right now, the only  thing you need to do to help your claim is to order a copy of your cfile, preparing for an appeal in case you need it, and get a hobby while you await the decision.  Yes, you can submit all the favorable evidence, and send it to the intake center not to the RO to shred.  

[Guest]

The Crazy one here, IMHO you filed a claim for an increase and VA has not made a decision yet.  You have evidence in your possession that could help win your claim (VOC REHAB LETTER and IMO/IME) if you wait for VA to make a decision you risk having to file an appeal which could take several year to resolve.  Get that evidence in VA hands as soon as possible. Since you are already service connected I don't think you need a BDQ but you would need treating progress reports that supports that you are as least likely as not unemployable due to your service connected disabilities.

[manni]

Thanks everyone for your help, So the TBI and PTSD exam concluded that my disability won't prevent me from working, while this one states otherwise, Do you this this eye exam will be enough to qualify me for TDIU?

Edited March 25, 2016 by manni

[Guest]

I would say that if you have positive evidence that proves that you are entitled to an increase, never withhold this evidence from the rating specialist.  You may regret it while you wait for VA to process your appeal.

[manni]

Any idea about my eyes exam?? Anyone....