ptsd DRO Hearing 3/31/16

[mbl22885]

As the title states, I have a DRO hearing at the end of this month. The issue at hand is over permanent and total for PTSD..

1. I am currently 100% scheduler for PTSD

2 I also receive SMC L Aid and Attendance for PTSD, it is temporary.

The decision letter with the denial for permanent and total reads as follows

"PLEASE NOTE: The date of entitlement to DEA (Chapter 35) is presumed based on the last date of SMC at L or higher. If a future examination is warranted for other purposes and there is potential for a reduction below 100%, do NOT grant entitlement to Chapter 35. Please note, that you have been granted additional disabilities such as fibromyalgia and entitlement to special monthly compensation as Aid and Attendance. Although the medical evidence notes your PTSD is chronic in nature with minimal likelihood of improvement, your other entitlements are not considered to be permanent and total, therefore, a future exam will be requested in order to determine your current level of disability and prognosis at that time. Based on your age and apparent willingness to seek treatment, it is found that an additional examination should be conducted in the future to determine whether or not your disability has stabilized. At that time the issue of entitlement to a permanent and total evaluation and subsequent entitlement to Dependents' Educational Assistance under 38 U.S.C. chapter 35 will be revisited."

 

First, wtf? Second, isn't "Although the medical evidence notes your PTSD is chronic in nature with minimal likelihood of improvement, your other entitlements are not considered to be permanent and total, therefore, a future exam will be requested in order to determine your current level of disability and prognosis at that time." Basically saying "Your PTSD is permanent and total." Worse, the rationale I'm taking away from this is " Not everything wrong with you is permanent and total, so nothing wrong with you can be permanent and total."

What I'm gathering from my VSO is that they're going to try to deny based on the SMC L not being permanent, or they're going to try to order a c and p to determine if it is. Obviously, I'm not okay with that. Plus, given what's stated at the top of denial "and there is potential for a reduction below 100%," isn't that saying it doesn't matter if my SMC L is permanent, so long as my PTSD remains permanent and total, like they've tacitly admitted in this denial letter?

 Assume I have an abundance of evidence to support the PTSD being p and t here. My VSO sucks. Any advice on how to mount a defense here?

 

 

[Gastone]

Help me out here, too lazy to go back and read all your posts. Your under 55, have a PTSD 100% Scheduler Rating plus additional SC's that total over 50% by themselves, right?

You also have a Temporary SMC L for your PTSD, but not SMC S (1) or (2)?

Your DRO is for a T & P rating on your PTSD, or is it for the SMC L?

Looked at 1 of your earlier posts, where you were having trouble attaching redacted Documents. Did you ever get them posted?

Seeing your redacted initial Awards and Denials would be helpful. What N & M Post Denial Evidence, have you submitted to the DRO?

Appears you got to the DRO Hearing in less than 2 yrs. Maybe things have really changed at the VA, what RO are you in?

Semper Fi

[Gastone]

Cancel my last, just looked back, we've already discussed this. Did you ever post your Redacted Doc's?

Still think your going to get a DRO Denial on the PTSD, as per our previous discussion. VA won't concede a MH issue can't improve over time, with treatment. Your what, 36 now? I just don't see the DRO going your way.

Your young, Appeal On! When you hit 55, if your still Fracked Up, T & P should be easier.

Semper Fi

[Buck52]

I agree with Gastone,

I would suggest that you stay in treatment with the VA And when your called for re-evaluation then seek medical records as N&M evidence that your disability has worsen or stayed the same   ask for P&T  then.

As for as asking DRO for P&T..Unless you have New &Material evidence  I can't see the DRO approving you for P&T.

JMO However  I could be wrong

...............Buck

[mbl22885]

2 hours ago, Gastone said:

Help me out here, too lazy to go back and read all your posts. Your under 55, have a PTSD 100% Scheduler Rating plus additional SC's that total over 50% by themselves, right?

You also have a Temporary SMC L for your PTSD, but not SMC S (1) or (2)?

Your DRO is for a T & P rating on your PTSD, or is it for the SMC L?

Looked at 1 of your earlier posts, where you were having trouble attaching redacted Documents. Did you ever get them posted?

Seeing your redacted initial Awards and Denials would be helpful. What N & M Post Denial Evidence, have you submitted to the DRO?

Appears you got to the DRO Hearing in less than 2 yrs. Maybe things have really changed at the VA, what RO are you in?

Semper Fi

Pretty much got it all right.

Let me work on redacting more documents. This is a copy of the decision letter denial. Added the opinion of the VES psychologist the VA sent me to on the likelihood of improvement of my PTSD. Also included an IMO that supports P and T.

FOTAD97(1).JPG (1).pdf

VESClarification.pdf

FairchildPT (2).pdf

Edited March 18, 2016 by mbl22885
New Docs

[mbl22885]

Like, they're not denying me because my PTSD isn't P and T. They even acknowledge that it is. They're denying me because everything else wrong with me besides PTSD is not P and T.

Edited March 18, 2016 by mbl22885
misspell

[mbl22885]

I don't think a copy of that VES clarification was supposed to go in my file.

I had filed for a number of things outsides of p and t however long ago. All the c and ps for the things I had filed for came in, but the psychologist hadn't rendered an opinion on whether my PTSD was P and T. The VA ended up closing out the bulk of the rest of my claim and deferring an opinion on P and T for PTSD until they could get a clarification from the psychologist who conducted my c and p.

However much time goes by and I get a call to schedule a C and P with a psychologist at my local VA clinic. I bring up how there was supposed to be a clarification letter from the psychologist I had already seen, but whoever said there was no record of it. I end up calling VES directly to ask about it and they say that the clarification was been completed by the provider and submitted to the VA. Long story short, I go back and forth with the VARO and VES until I get in contact with two people high enough from the VARO and VES that the VES person directly submits the clarification to the VARO person.

All the while that this happens, my VSO is telling me to drop it and just go to the new c and p, as well as anybody else that is supposed to be in my corner.

My paranoid side tells me the VA didn't want the VES clarification in my file because it's favorable to a permanent and total rating for PTSD. My paranoid side also tells me that the VA wanted me to go to a VA psychologist for an opinion on my PTSD being p and t because the VA takes the stance that PTSD is curable.

This is just me venting btw.