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C&P Exam for PTSD increase - might have backfired!


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C&P Exam PTSD:MST Eating Disorder.pdf

^^^^^^Well the attached report indicates to me a 10% PTSD rating.  I am currently 30% and I do not understand how this happened but I might be in for a reduction.  I thought the exam went well.  I had a PTSD and Eating Disorder C&P.  

Regarding the occupational/social impairment she checked the one that resembles 10% and for "b" she marks YES and goes on to say my trauma impacts my occupational/social impairment.

Look at the symptoms she notes:

Anxiety; Panic Attacks more than once a week; Chronic sleep impairment; difficulty in establishing and maintaining effective work and social relationships

She even stated in the exam that I was BDD (Body Dysmorphic Disorder) but her reports indicates while I have BDD characteristics I don't warrant the BDD rating.

She states for the VA established diagnosis of SPECIFIED TRAUMA AND STRESSOR RELATED DISORDER, there is NO CHANGE in the diagnosis.  At this time the claimant's condition is active.

Does this Exam mean I am going to be reduced or would I fall under the below???

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.

 

Edited by Navy4life
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Tip I learned recently If they send you a proposal to reduce immediately request a personal hearing within 30 days and file a new claim for increase within the 60 day period following and you will get

Every reduction proposal comes with a letter that says if you don't agree with the adverse action you have the right to personal hearing if requested within 30 days of the date of the proposal to redu

Wow I just now seen this post this is great news Navy4life  good for you girl   this puts you close to 100%  right? way to go girl   Nice Pic btw ..................Buck

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Navy4life, its very hard to say with VA. Other members are far more qualified to give advice on this, but here goes. First, look up the NP/Docs name, research their background and look at qualifications. Even if they are a Doctor, if they are, say, an Orthopedic Surgeon then what is she doing giving rxams to detetmine severity of ptsd? If she has a different field of specialty, write up a statement challenging the exam and bring it to your hearing. To write your statement, look up Junk science invades VA like ants at a picnic. Mr Attig tells us exactly how(what phrases to include), to challenge the exam. Good Luck!!

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3 minutes ago, flores97 said:

Navy4life, its very hard to say with VA. Other members are far more qualified to give advice on this, but here goes. First, look up the NP/Docs name, research their background and look at qualifications. Even if they are a Doctor, if they are, say, an Orthopedic Surgeon then what is she doing giving rxams to detetmine severity of ptsd? If she has a different field of specialty, write up a statement challenging the exam and bring it to your hearing. To write your statement, look up Junk science invades VA like ants at a picnic. Mr Attig tells us exactly how(what phrases to include), to challenge the exam. Good Luck!!

Flores;

I will look her up now but I just edited my thread above to include the 3.344 Stabilization of disability evaluations...Thoughts?  At this point if I don't get reduced, which I know won't happen right now, BTW this is for my FDC claim, I am okay with remaining at 30% with a potential rate reduction down the road.  After all I am in therapy and if I get better great but heck I know I am not at 10% PTSD by any means!

FYI she is a Psychiatrist/Psychologist....

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How long have you had the PTSD rating, Navy?

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Just now, flores97 said:

How long have you had the PTSD rating, Navy?

I was rated in 2014.  My original file was in 2013.  They gave me the PTSD/MST from the 1990's while in the military along with the Eating Disorder in the 1990's as well

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Sorry for the late response, I'm not feeling too well this evening. Since she is a specialist, and your hearing is in two days, i would speak to the DRO about your symptoms and bring as much evidence as possible. If the DRO seems undecided, try to get another IMO or DBQ filled out asap to counter that exam. Since you are already sc for ptsd, it doesnt have to be a VA doctor, just make sure he/she is a psychiatrist/psychologist. I hope everything goes great at your hearing, Navy4life, you can do it!

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